Organization Active NPI

Active Therapy Management LLC

  • Assisted Living Facility
  • Henderson, TX
National Provider Identifier
1376416875
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
ACTIVE THERAPY MANAGEMENT LLC
Practice address
1905 Old Nacogdoches Rd
Henderson, TX 75654-4630
Phone
(903) 657-1563
NPI assigned
Sep 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Authorized official

Name
Ashok Gupta, PTNPI 1124464847
Title
Ceo
Phone
(954) 702-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1905 Old Nacogdoches Rd
Henderson, TX 75654-4630

Mailing address

1918 E Front St
Tyler, TX 75702-8511

Other names 1

  • Pine Lodge Assisted Living Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2048678Pine Lodge Assisted Living1905 Old Nacogdoches Rd, Henderson, TX 75654Certificate of waiverOct 21, 2026

National Provider Directory

National Provider Directory

Locations

1918 E Front St
Tyler, TX 75702
Phone (844) 797-0669

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1376416875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 E FRONT ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 OLD NACOGDOCHES RD",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756544630",
            "telephone_number": "903-657-1563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE THERAPY MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "ASHOK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-702-3000",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Lodge Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.