Provider Demographics
NPI:1003316886
Name:ACTIVE HEALTH SOLUTIONS PLLC
Entity Type:Organization
Organization Name:ACTIVE HEALTH SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:KEENER
Authorized Official - Last Name:KOSLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:240-630-2248
Mailing Address - Street 1:901 N POLLARD ST APT 812
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-4091
Mailing Address - Country:US
Mailing Address - Phone:419-944-8882
Mailing Address - Fax:
Practice Address - Street 1:901 N POLLARD ST APT 812
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-4091
Practice Address - Country:US
Practice Address - Phone:419-944-8882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-18
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT871941251E00000X
VA2305211698251E00000X
MD26855251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health