Organization
ACTIVE CHANGE RECOVERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN SISNEROZ (CEO)
(209) 921-0971
Entity
Organization
Contact information
Practice address
229 E WEBER AVE STE 103, STOCKTON, CA 95202-2751
(209) 921-0971
Mailing address
1738 BARTLETT CT, STOCKTON, CA 95206-6358
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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