Organization
ACTIVE LIFE SOLUTIONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL A LAINE RPT (PRESIDENT)
(561) 758-8810
Entity
Organization
Contact information
Practice address
850 W INDIANTOWN RD, SUITE C, JUPITER, FL 33458-7539
(561) 386-8311
(561) 748-8551
Mailing address
6671 W INDIANTOWN RD, # 50-438, JUPITER, FL 33458-3991
(561) 386-8311
(561) 748-8551
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
ME0076092
FL
Other
Enumeration date
04/20/2010
Last updated
04/20/2010
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