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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