Active NPI
Active Community Health Center Corp
- Community/Behavioral Health Agency
- Pembroke Pines, FL
National Provider Identifier
1245801091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- ACTIVE COMMUNITY HEALTH CENTER CORP
- Practice address
- 6830 Pines Blvd
Pembroke Pines, FL 33024-7545 - Phone
- (954) 333-8787
- Fax
- (954) 333-8621
- NPI assigned
- Jul 2, 2021
- Last updated
- Jul 19, 2021
- Organization subpart
- Yes
- Parent organization
- ACTIVE COMMUNITY HEALTH CENTER, CORP
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pablo Uriarte, LCSW
- Title
- Ceo
- Phone
- (954) 394-3095
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | NU | Primary |
Addresses
Primary practice location
6830 Pines Blvd
Pembroke Pines, FL 33024-7545
Mailing address
19321 SW 14TH St
Pembroke Pines, FL 33029-6124
Phone (954) 394-3095
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008779301 | Medicaid | FL |
National Provider Directory
National Provider Directory- Part of
- Active Community Health Center Corp
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Clinical Social Worker
- Sunrise, FL
- NPI 1669618849
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625184000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1626652800000",
"number": "1245801091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19321 SW 14TH ST",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330296124",
"telephone_number": "954-394-3095",
"fax_number": "954-333-8621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6830 PINES BLVD",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330247545",
"telephone_number": "954-333-8787",
"fax_number": "954-333-8621"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ACTIVE COMMUNITY HEALTH CENTER CORP",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ACTIVE COMMUNITY HEALTH CENTER, CORP",
"enumeration_date": "2021-07-02",
"last_updated": "2021-07-19",
"certification_date": "2021-07-19",
"status": "A",
"authorized_official_last_name": "URIARTE",
"authorized_official_first_name": "PABLO",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "954-394-3095",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008779301",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.