Active Life Health Care Management, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

ACTIVE LIFE HEALTH CARE MANAGEMENT, LLC

Practice address

783 Water St
Fitchburg, MA 01420-6479

Phone

(978) 400-7604

Fax

(978) 268-5242

NPI assigned

Jan 2, 2018

Organization subpart

No

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

Authorized official

Name

Vladimir Giterman

Title

Owner

Phone

(978) 400-7604

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514851200000",
    "number": "1104333087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "783 WATER ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014206479",
            "telephone_number": "978-400-7604",
            "fax_number": "978-268-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "783 WATER ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014206479",
            "telephone_number": "978-400-7604",
            "fax_number": "978-268-5242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE HEALTH CARE MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-02",
        "last_updated": "2018-01-02",
        "status": "A",
        "authorized_official_last_name": "GITERMAN",
        "authorized_official_first_name": "VLADIMIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-400-7604"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Day Care Clinic/Center in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• Adult Day Care Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.