OrganizationActive
Active Adults Program LLC
NPI 1093685133 · Case Management Agency · San Diego, CA
Provider details
- NPI number
- 1093685133
- Entity type
- Organization
- Primary specialty
- Case Management AgencyAgencies
- Organization subpart
- No
- Authorized official
- Estreanda Fulford, Ceo(619) 908-2643
Specialties & taxonomies
Agencies
Practice location
7940 Silverton Ave Ste 204
San Diego, CA 92126-6341
Phone: (619) 908-2643
Approximate (ZIP-level) locationGet directions
Mailing address
11475 Hadar Dr
San Diego, CA 92126-1361
Registry dates
- Enumerated
- 2025-11-05
- Last updated
- 2025-11-05
- Certified
- 2025-11-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.