Active Life Therapies LLC

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

ACTIVE LIFE THERAPIES LLC

Practice address

2776 Delaware Ave
Kenmore, NY 14217-2740

Phone

(716) 332-0404

Fax

(716) 871-1998

NPI assigned

Feb 21, 2017

Last updated

Feb 21, 2017By 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

Mr. Jeffrey O Dann

Title

Owner/Ceo

Phone

(716) 510-2470

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1851830046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2776 DELAWARE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142172740",
            "telephone_number": "716-332-0404",
            "fax_number": "716-871-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2776 DELAWARE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142172740",
            "telephone_number": "716-332-0404",
            "fax_number": "716-871-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE THERAPIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "DANN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "716-510-2470",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Comprehensive Outpatient Rehabilitation Facility (CORF) in Kenmore, NY
• Providers in Kenmore, NY by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.