ACTIVE HOME CARE SERVICES INC (NPI# 1659882066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659882066 |
| Entity Type | Organization |
| Organization Name | ACTIVE HOME CARE SERVICES INC |
| Practice Address |
4600 Powder Mill Rd Ste 450z5 Beltsville MD 20705-2675 |
| Practice Telephone | 2405424240 |
| Practice Fax Number | 2405424047 |
| Mailing Telephone | 2405424240 |
| Mailing Fax Number | 2405424047 |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2019-09-13 |
| Authorized Official Name | MR. SHADRACK JORAM BAMPEBUYE (ADMINISTRATOR / OWNER) |
| Authorized Official Telephone | 3016834270 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WH0200X |
Registered Nurse Specialization: Home Health |
Nursing Service Providers | ||
| N | 163WW0000X |
Registered Nurse Specialization: Wound Care |
Nursing Service Providers | ||
| N | 224Z00000X | Occupational Therapy Assistant | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 251E00000X | Home Health | Agencies | ||
| N | 253Z00000X | In Home Supportive Care | Agencies | ||
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| N | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 163WC1500X |
Registered Nurse Specialization: Community Health |
Nursing Service Providers |
| Other Name | Type Code |
|---|---|
| ACTIVE HOME CARE SERVICES LLC | Doing Business As Name - Organization |
| Street Address |
4600 POWDER MILL RD STE 450Z5 |
| City | BELTSVILLE |
| State | MD |
| Zip Code | 20705-2675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730318 | My Clinical Coordinator LLC | Nurse Practitioner | 11720 Belsville Drive, Suite 500-a44, Beltsville, MD 20705 | 2020-11-04 |
| 1306454129 | Anastasi Ward | Technician | 4009 Lakehouse Road, Beltsville, MD 20705 | 2020-07-17 |
| 1750942512 | City Access LLC | Pharmacy | 11466 Cherry Hill Road, Silver Spring, MD 20705 | 2019-06-24 |
| 1972089225 | Emily Hemphill | Behavior Technician | 3917 Howard Rd, Beltsville, MD 20705 | 2018-07-18 |
| 1457841629 | Vijayalakshmi Jesson Dds PC | Dentist | 10820 Rhode Island Ave Ste A, Beltsville, MD 20705 | 2018-05-14 |
| 1942704465 | Ana Lisette Cordon | Behavior Technician | 12603 Bear Creek Ter, Beltsville, MD 20705 | 2018-03-20 |
| 1841718608 | Premier Health Care LLC | Psychiatry & Neurology | 4600 Powder Mill Rd Ste Z1, Beltsville, MD 20705 | 2017-08-31 |
| 1104357094 | Byron Adams | Social Worker | 12050 Baltimore Avenue, Beltsville, MD 20705 | 2017-03-23 |
| 1598213936 | Suita Healthcare Services | Home Health | 4517 Sellman Road, Suit G, Beltsville, MD 20705 | 2016-09-14 |
| 1578910246 | Kadiatu Turay | Technician | 11457 Cherry Hiill Rd #303, Beltsville, MD 20705 | 2016-05-23 |
| Find all providers in zip 20705 | ||||
| Taxonomy Code | 163WC1500X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372302 | Deborah Bena | Registered Nurse | 5601 Loch Raven Blvd Bldg G4, Baltimore, MD 21239-2945 | 2020-09-25 |
| 1508492471 | Lisa Tran | Registered Nurse | 2201 Argonne Dr, Baltimore, MD 21218-1627 | 2020-03-22 |
| 1336787100 | Kawana Jeffer Williams | Registered Nurse | 10145 Campus Way S, Upper Marlboro, MD 20774-2105 | 2019-12-12 |
| 1639666217 | Karen Michele Banks | Registered Nurse | 9902 Spanish Oak Way, Bowie, MD 20721-3706 | 2018-04-18 |
| 1639675002 | Theresa Granitto | Registered Nurse | 14630 Keeneland Cir, North Potomac, MD 20878-3771 | 2018-04-03 |
| 1245744952 | Tracie Gibson | Registered Nurse | 9105 Franklin Square Dr Fl 3, Baltimore, MD 21237-3930 | 2017-11-17 |
| 1619480308 | Valorie Elaine Colby | Registered Nurse | Eastern Family Resource Center, 9150 Franklin Square Drive, Rosedale, MD 21237 | 2017-11-16 |
| 1518479880 | Nicole Anderson | Registered Nurse | 5514 Aeriel Pl, Frederick, MD 21703-6555 | 2017-10-26 |
| 1144640145 | Sara Harvey | Registered Nurse | 6401 York Rd, 3rd Floor, Baltimore, MD 21212-2130 | 2014-04-17 |
| 1700221884 | Stanley Hess | Registered Nurse | 610 E Diamond Ave Ste 300, Gaithersburg, MD 20877-5321 | 2013-05-02 |
| Find all providers with the same taxonomy | ||||
| City | BELTSVILLE |
| Zip Code | 20705 |
Please comment or provide details below to improve the information on ACTIVE HOME CARE SERVICES INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.