Provider Demographics
NPI:1982115101
Name:ACTIVE CARE SERVICES INC
Entity Type:Organization
Organization Name:ACTIVE CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MULINDWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-354-7863
Mailing Address - Street 1:300 BELLANCA RD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6877
Mailing Address - Country:US
Mailing Address - Phone:732-862-7962
Mailing Address - Fax:
Practice Address - Street 1:300 BELLANCA RD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6877
Practice Address - Country:US
Practice Address - Phone:732-862-7962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-15
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0267300374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty