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Organization

ACTIVE HOME CARE SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SHADRACK JORAM BAMPEBUYE (ADMINISTRATOR / OWNER)
(301) 683-4270
Entity
Organization

Contact information

Practice address
9211 CORPORATE BLVD STE 255, ROCKVILLE, MD 20850-3856
(240) 238-1110
(240) 238-1112
Mailing address
9211 CORPORATE BLVD STE 255, ROCKVILLE, MD 20850-3856
(240) 238-1110
(240) 542-4047

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
163WW0000X
Wound Care Registered Nurse
224Z00000X
Occupational Therapy Assistant
3140N1450X
Pediatric Skilled Nursing Facility
Primary
364SA2200X
Adult Health Clinical Nurse Specialist

Other

Enumeration date
10/12/2017
Last updated
07/22/2025
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