Provider Demographics
NPI:1689998122
Name:ACTIVE HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:ACTIVE HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ATTAULLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-403-3827
Mailing Address - Street 1:12701 TELEGRAPH RD STE 203A
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-6851
Mailing Address - Country:US
Mailing Address - Phone:734-403-3827
Mailing Address - Fax:
Practice Address - Street 1:12701 TELEGRAPH RD STE 203A
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-6851
Practice Address - Country:US
Practice Address - Phone:734-403-3827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health