OrganizationActive
Integrated-Activhealthcare, LLC
NPI 1104967850 · Preferred Provider Organization · Lilburn, GA
Provider details
- NPI number
- 1104967850
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Mark Brickhouse, Director of Operations(770) 455-0040
Specialties & taxonomies
Managed Care Organizations
Practice location
4566 Lawrenceville Hwy Nw
Lilburn, GA 30047-3618
Phone: (770) 455-0040
Fax: (770) 455-6188
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 969
Lilburn, GA 30048-0969
Registry dates
- Enumerated
- 2007-02-08
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.