NPIMap

Organization Active NPI

Active SC One, Inc.

Doing business as Club Horizons of Charleston

  • Adult Day Care Clinic/Center
  • North Charleston, SC
National Provider Identifier
1073086377
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
ACTIVE SC ONE, INC.
Doing business as
Club Horizons of Charleston
Practice address
8088 Rivers Ave
North Charleston, SC 29406-9235
Phone
(843) 992-2432
NPI assigned
Jan 9, 2019
Last updated
Oct 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Debora Hockenbury
Title
Contracts Manager
Phone
(215) 642-6600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary
Respite Care 385H00000X

Addresses

Primary practice location

8088 Rivers Ave
North Charleston, SC 29406-9235

Mailing address

6 Neshaminy Interplex, Suite 401
Trevose, PA 19053
Phone (215) 642-6600

Other names 1

  • Club Horizons of Charleston Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Active SC One Inc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

8088 Rivers Ave
North Charleston, SC 29406
Phone (202) 304-3971

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1073086377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 NESHAMINY INTERPLEX, SUITE 401",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "19053",
            "telephone_number": "215-642-6600",
            "fax_number": "215-642-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8088 RIVERS AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069235",
            "telephone_number": "843-992-2432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE SC ONE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "HOCKENBURY",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_title_or_position": "CONTRACTS MANAGER",
        "authorized_official_telephone_number": "215-642-6600"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Club Horizons of Charleston",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Club Horizons of Charleston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.