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Organization

ACTIVE PROVIDER SERVICE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOANN GOMEZ (CEO)
(210) 993-4000
Entity
Organization

Contact information

Practice address
29906 PREMIERE, BULVERDE, TX 78163-2525
(210) 993-0000
Mailing address
29906 PREMIERE, BULVERDE, TX 78163-2525
(210) 993-4000

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
3747P1801X
Personal Care Attendant
Primary

Other

Enumeration date
04/09/2020
Last updated
07/08/2024
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