Provider Demographics
NPI:1699574111
Name:ACTIVEHANDSHOMECARE LLC
Entity type:Organization
Organization Name:ACTIVEHANDSHOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANNISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-481-1938
Mailing Address - Street 1:202 3RD LOOP RD STE D12
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-3795
Mailing Address - Country:US
Mailing Address - Phone:843-481-1938
Mailing Address - Fax:
Practice Address - Street 1:202 3RD LOOP RD STE D12
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-3795
Practice Address - Country:US
Practice Address - Phone:843-481-1938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care