Active Life Services Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

ACTIVE LIFE SERVICES INC

Practice address

260 Geiger Rd
Philadelphia, PA 19115-1008

Phone

(267) 258-3396

NPI assigned

Jan 30, 2021

Organization subpart

No

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

Authorized official

Name

Marina Amerkhanova

Title

Owner

Phone

(267) 258-3396

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1611964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611964800000",
    "number": "1215528443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 GEIGER RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191151008",
            "telephone_number": "267-258-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 GEIGER RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191151008",
            "telephone_number": "267-258-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-30",
        "last_updated": "2021-01-30",
        "certification_date": "2021-01-30",
        "status": "A",
        "authorized_official_last_name": "AMERKHANOVA",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-258-3396"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Developmentally Disabled Services Day Training Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2021; 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.