Provider Demographics
NPI:1730101700
Name:ACTIVE HOME HEALTH CARE SERVICE, INC
Entity Type:Organization
Organization Name:ACTIVE HOME HEALTH CARE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANSOOR
Authorized Official - Middle Name:I
Authorized Official - Last Name:BHATTI
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:734-752-1209
Mailing Address - Street 1:2527 S 11TH ST
Mailing Address - Street 2:SUITE # 2
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-4747
Mailing Address - Country:US
Mailing Address - Phone:269-262-0685
Mailing Address - Fax:269-262-4159
Practice Address - Street 1:2527 S 11TH ST
Practice Address - Street 2:STE 2
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-4747
Practice Address - Country:US
Practice Address - Phone:269-262-0685
Practice Address - Fax:269-262-4159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health