Organization
ACTIVE LIFE THERAPIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY O DANN (OWNER/CEO)
(716) 510-2470
Entity
Organization
Contact information
Practice address
2776 DELAWARE AVE, KENMORE, NY 14217-2740
(716) 332-0404
(716) 871-1998
Mailing address
2776 DELAWARE AVE, KENMORE, NY 14217-2740
(716) 332-0404
(716) 871-1998
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
02/21/2017
Last updated
02/21/2017
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