NPIMap

Organization Active NPI

Active SC One, Inc.

Doing business as Active Day of Pee Dee

  • Adult Day Care Clinic/Center
  • Florence, SC
National Provider Identifier
1982744272
Registry record updated Jun 30, 2020
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
Active Day of Pee Dee
Pee Dee Active Day Center
Practice address
2120 Enterprise Dr
Florence, SC 29501-1104
Phone
(843) 665-1919
Fax
(843) 665-7237
NPI assigned
Feb 7, 2007
Last updated
Jun 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ACTIVE DAY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary
Respite Care 385H00000X SC

Addresses

Primary practice location

2120 Enterprise Dr
Florence, SC 29501-1104

Mailing address

6 Neshaminy Interplex Dr
Suite 401
Trevose, PA 19053-6964
Phone (215) 642-6600

Other identifiers 1

IdentifierTypeStateIssuer
EX0431MedicaidSC

Other names 2

  • Active Day of Pee Dee Doing business as
  • Pee Dee Active Day Center Doing business as

National Provider Directory

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

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1982744272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 NESHAMINY INTERPLEX DR",
            "address_2": "SUITE 401",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536964",
            "telephone_number": "215-642-6600",
            "fax_number": "215-642-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 ENTERPRISE DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295011104",
            "telephone_number": "843-665-1919",
            "fax_number": "843-665-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE SC ONE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACTIVE DAY, INC.",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "HOCKENBURY",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_title_or_position": "CONTRACTS MANAGER",
        "authorized_official_telephone_number": "215-642-6600"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EX0431",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Day of Pee Dee",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pee Dee Active Day Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.