Organization
ACTIVE THERAPY MANAGEMENT LLC
Active
Other names
Pine Lodge Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
ASHOK GUPTA PT (CEO)
(954) 702-3000
Entity
Organization
Contact information
Practice address
1905 OLD NACOGDOCHES RD, HENDERSON, TX 75654-4630
(903) 657-1563
Mailing address
1918 E FRONT ST, TYLER, TX 75702-8511
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/29/2025
Last updated
09/29/2025
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