Provider Demographics
NPI:1205294196
Name:ACTIVE CARE HOME HEALTH, LLC
Entity type:Organization
Organization Name:ACTIVE CARE HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUCHOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-932-2888
Mailing Address - Street 1:9850 NICHOLAS ST STE 300
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2187
Mailing Address - Country:US
Mailing Address - Phone:402-932-2888
Mailing Address - Fax:402-932-2899
Practice Address - Street 1:9850 NICHOLAS ST STE 300
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2187
Practice Address - Country:US
Practice Address - Phone:402-932-2888
Practice Address - Fax:402-932-2899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health