| Organization Name: | ACTIVE LIFE REHAB INC. |
| NPI Number: | 1053492371 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATRICK TIMOTHY CRISLER (VISE PRESIDENT) |
| Mailing Address: | 3589 E Gulf To Lake Hwy Inverness |
| State: | FL US |
| Postal Code: | 344533208 |
| Phone Number: | 3528602222 |
| Fax Number: | 3528602223 |
| NPI Enumeration Date: | 10/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |