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Street Address

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1501 CORPORATE DR STE 270
BOYNTON BEACH, FL 33426
Phone: (561) 572-3777
County: Palm Beach

Mailing Address

1501 CORPORATE DR
STE 260
BOYNTON BEACH, FL 33426-6661
County: Palm Beach
Website: http://WWW.ACTIVAHH.COM

Emergency Actions:

None
Facility/Provider Type: Nurse Registry
Administrator: JONATHAN JAMES FEDELE
Financial Officer: JONATHAN JAMES FEDELE
Owner/Licensee: ACTIVA HOMECARE LLC
Owner/Licensee Since: 4/6/2012
NamePositionOwnership
OCEAN HEALTHCARE HOLDINGS LLC 100%
JONATHAN JAMES FEDELEBOARD MEMBER/OFFICER0%
KYLE MIKOBOARD MEMBER/OFFICER0%
STEVEN F LICABOARD MEMBER/OFFICER0%
Profit Status: For-Profit
Licensed Beds: Not Available
AHCA Number (File Number): 42963197
AHCA Field Office: 09
License Number: 30211566
Current License Effective: 10/15/2016
Expires: 5/21/2018
License Status: LICENSED
Name changes (past 24 months):
NameLast Used
ACTIVA HOMECARE LLC03/15/2016
ACTIVA HOMECARE03/15/2016

Services/Characteristics:

Service Area :  Indian Riv, Martin, Okeechobee, Palm Beach, St. Lucie

Consumer Guides:



Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.
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