Organization
ACTIVE HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTLY L THOMPSON (PRESIDENT)
(678) 251-7265
Entity
Organization
Contact information
Practice address
6040 W LISBON AVE, SUITE 104, MILWAUKEE, WI 53210-2116
(414) 350-5749
(414) 210-5549
Mailing address
6040 W LISBON AVE, SUITE 104, MILWAUKEE, WI 53210-2116
(414) 350-5749
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100054758
—
WI
Enumeration date
09/27/2016
Last updated
09/27/2016
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