Provider Demographics
NPI:1932524287
Name:ACTIVE LIVING HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:ACTIVE LIVING HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LMSW
Authorized Official - Phone:313-535-1838
Mailing Address - Street 1:24801 5 MILE RD
Mailing Address - Street 2:SUITE 20
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-3655
Mailing Address - Country:US
Mailing Address - Phone:313-535-1838
Mailing Address - Fax:313-255-5097
Practice Address - Street 1:24801 5 MILE RD
Practice Address - Street 2:SUITE 20
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3655
Practice Address - Country:US
Practice Address - Phone:313-535-1838
Practice Address - Fax:313-255-5097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health