Provider Demographics
NPI:1912133208
Name:INFINITY HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:INFINITY HEALTH SERVICES, INC.
Other - Org Name:ACTIVA HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-421-0191
Mailing Address - Street 1:1501 CORPORATE DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-6600
Mailing Address - Country:US
Mailing Address - Phone:561-819-0460
Mailing Address - Fax:561-207-7843
Practice Address - Street 1:12350 NW 39TH ST STE 203
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-2418
Practice Address - Country:US
Practice Address - Phone:561-819-0460
Practice Address - Fax:954-364-8574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993504251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10-9628Medicare PIN