Organization
ACTIVECARE PROVIDER SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL PREVOST (ADMINISTRATOR)
(346) 319-0229
Entity
Organization
Contact information
Practice address
8700 COMMERCE PARK DR STE 218-B, HOUSTON, TX 77036-7497
(346) 319-0229
Mailing address
8700 COMMERCE PARK DR STE 218-B, HOUSTON, TX 77036-7497
(346) 319-0229
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
12/13/2016
Last updated
12/14/2018
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