NPIMap

Organization Active NPI

Active SC One, Inc.

Doing business as HopeBridge Hollies of Active Day

  • Adult Day Care Clinic/Center
  • West Columbia, SC
National Provider Identifier
1780315929
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
ACTIVE SC ONE, INC.
Doing business as
HopeBridge Hollies of Active Day
Practice address
2708 Hebron Dr
West Columbia, SC 29169-3012
Phone
(803) 791-3255
NPI assigned
Jun 20, 2022
Last updated
Jun 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Authorized official

Name
Debora Hockenbury
Title
Contracts MGR
Phone
(215) 642-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary

Addresses

Primary practice location

2708 Hebron Dr
West Columbia, SC 29169-3012

Mailing address

6 Neshaminy Interplex, Ste 401
Trevose, PA 19053-6942
Phone (215) 642-6600

Other names 1

  • HopeBridge Hollies of Active Day 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
42D2270195Hopebridge Hollies of Active Day2708 Hebron Drive, West Columbia, SC 29169Certificate of waiverOct 10, 2026

National Provider Directory

National Provider Directory
Tax ID family
Active SC One Inc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

2708 Hebron Dr
West Columbia, SC 29169
Phone (803) 791-3255

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655683200000",
    "number": "1780315929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 NESHAMINY INTERPLEX, STE 401",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536942",
            "telephone_number": "215-642-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 HEBRON DR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693012",
            "telephone_number": "803-791-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE SC ONE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A",
        "authorized_official_last_name": "HOCKENBURY",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_title_or_position": "CONTRACTS MGR",
        "authorized_official_telephone_number": "215-642-6600"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HopeBridge Hollies of Active Day",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.