Active Home Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ACTIVE HOME CARE INC

Practice address

1936 Ford Pkwy
Saint Paul, MN 55116-1929

Phone

(612) 532-3612

NPI assigned

Jan 22, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Iman Ibrahim Mohamed

Title

Director

Phone

(612) 532-3612

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453420800000",
    "number": "1710344692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55116",
            "telephone_number": "612-532-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161929",
            "telephone_number": "612-532-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE HOME CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-22",
        "last_updated": "2016-01-22",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "IMAN",
        "authorized_official_middle_name": "IBRAHIM",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "612-532-3612",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "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 Jan 22, 2016; 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.