Provider Demographics
NPI:1467596056
Name:ACTIVE MA, INC.
Entity Type:Organization
Organization Name:ACTIVE MA, INC.
Other - Org Name:ACTIVE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:NEHODA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-642-6600
Mailing Address - Street 1:6 NESHAMINY INTERPLEX DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6964
Mailing Address - Country:US
Mailing Address - Phone:215-642-6600
Mailing Address - Fax:215-642-6610
Practice Address - Street 1:1470 NEW STATE HIGHWAY
Practice Address - Street 2:RAYNHAM MARKET PLACE, UNIT 17
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767
Practice Address - Country:US
Practice Address - Phone:508-291-0752
Practice Address - Fax:508-291-7437
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACTIVE DAY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-16
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health