Active Life, Llc

LBN: Active Life, Llc
Active Life, Llc is an health care organization with primary practice located at 72780 Country Club Dr Ste 300 , Rancho Mirage CA 92270-4150. The organization recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as the primary health care specialty. Active Life, Llc can be contacted via phone (909) 748-0168, or through Doty, Spencer Arden via phone (858) 616-7724.

Contact Information

Primary practice address
72780 Country Club Dr Ste 300 Rancho Mirage CA 92270-4150
Phone: (909) 748-0168
Fax: (909) 748-5881
Website:
Map and Directions
Authorized official contact:
Name: Doty, Spencer Arden
Phone: (858) 616-7724

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X

Profile Details

NPI number 1083284590
LBN Legal business name Active Life, Llc
DBA Doing business as
Authorized official Doty, Spencer Arden
Entity Organization
Organization subpart 1 No
Enumeration date Jun 28th, 2021
Last updated Jun 28th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083284590 NPPES
California MEDICAID XC0009601

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