Organization
ACTIVE LIFE ADHC LLC
Active
Other names
Active Life ADHC LLC
Organization subpart
No
Provider details
NPI number
Authorized official
VITA COKER (EXECUTIVE DIRECTOR)
(502) 835-9419
Entity
Organization
Contact information
Practice address
102 BOOKSTORE WAY, BOWLING GREEN, KY 42101-2810
(502) 835-9419
Mailing address
102 BOOKSTORE WAY, BOWLING GREEN, KY 42101-2810
(502) 835-9419
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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