ACTIVE DAY OF GRAND STRAND
NPI 1619017027
Clinic/Center - Adult Day Care in Myrtle Beach, SC

Q: What is Active Sc One, Inc.'s NPI number?

The NPI number for Active Sc One, Inc. is 1619017027. It was assigned to this organization in the NPPES registry on February 7, 2007. The provider is doing business as Active Day Of Grand Strand.

Q: What is Active Sc One, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Day Care, with taxonomy code 261QA0600X.

Active since February 07, 2007CLIA 42D0981669 · Waiver

3880 HOUNDSFIELD AVE, MYRTLE BEACH, SC 29577(843) 626-8501(843) 916-8858 Get Directions Write a Review

NPPES record last updated: June 30, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 30, 2020, May 22, 2019 (2 updates tracked since 2019).

On this page

About Active Day Of Grand Strand NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ACTIVE DAY OF GRAND STRAND (NPI 1619017027) is a healthcare organization registered as an adult day care in Myrtle Beach, South Carolina and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through January 2, 2027 and lists Debora Hockenbury, Contracts Manager, as its authorized official.

NPPES Registry Identity

NPI1619017027

Entity TypeOrganization

Primary Taxonomy261QA0600X

Legal Business NameACTIVE SC ONE, INC.

Location Address3880 HOUNDSFIELD AVEMyrtle Beach, SC 29577-5792

Mailing Address6 Neshaminy Interplex Dr Ste 401Trevose, PA 19053-6942 · (215) 642-6600 · Fax (215) 642-6610

Phone(843) 626-8501

Fax(843) 916-8858

Organization SubpartYesParent: Active Day, Inc.

Authorized OfficialDebora HockenburyContracts Manager · (215) 642-6600

Enumeration DateFebruary 7, 2007

Last NPPES UpdateJune 30, 20202 updates tracked since enumeration

NPPES CertifiedJune 30, 2020

✔ NPI 1619017027 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adult Day CareAmbulatory Health Care Facilities

Taxonomy Code261QA0600X

3880 HOUNDSFIELD AVE, Myrtle Beach, SC 29577

Open in Google Maps ↗

Other Names 1

Doing Business AsActive Day Of Grand Strand

Other Identifiers 1

MedicaidEX0429SC

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D0981669

Active Day Of Grand Strand · Myrtle Beach, SC

Active · expires Jan 2, 2027

CLIA Number42D0981669

Laboratory TypeOther

Certificate Effective DateJanuary 3, 2025

Certificate Expiration DateJanuary 2, 2027

Laboratory DirectorWaides A. Ashmon

Laboratory Phone(843) 626-8501

Laboratory LocationActive Day Of Grand Strand3880 Houndsfield Ave, Myrtle Beach, SC 29577

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Active Sc One, Inc.'s NPI number?

The NPI number for Active Sc One, Inc. is 1619017027. It was assigned to this organization in the NPPES registry on February 7, 2007. The provider is doing business as Active Day Of Grand Strand.

Where is Active Sc One, Inc. located?

Active Sc One, Inc. is located at 3880 Houndsfield Ave, Myrtle Beach, SC 29577. The listed phone number is (843) 626-8501.

What is Active Sc One, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Day Care, with taxonomy code 261QA0600X.

Does Active Sc One, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D0981669) is associated with this NPI, valid through January 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Active Sc One, Inc. was last updated on June 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.