Active Way Healthcare Services, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

ACTIVE WAY HEALTHCARE SERVICES, LLC

Practice address

3521 N California Ave
Suite C
Peoria, IL 61603-1171

Phone

(309) 693-7665

NPI assigned

Aug 8, 2011

Last updated

Aug 8, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Sandi L Lawson

Title

Ceo

Phone

(309) 693-7665

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312761600000",
    "number": "1467731539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 N CALIFORNIA AVE",
            "address_2": "SUITE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616031171",
            "telephone_number": "309-693-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 N CALIFORNIA AVE",
            "address_2": "SUITE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616031171",
            "telephone_number": "309-693-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE WAY HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-08",
        "last_updated": "2011-08-08",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "SANDI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-693-7665",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.