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NPI Code Detail

MEDICARE: ACTIVE DAY OH, INC.

MEDICARE: ACTIVE DAY OH, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency
2261QA0600XAdult Day Care Clinic/Center

General Provider Information

NPI Number : 1518499391
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACTIVE DAY OH, INC.
Provider Business Mailing Address
First Line : 6 NESHAMINY INTERPLEX
Second Line : SUITE 401
City : TREVOSE
State : PA
Zip : 19053-6964
Country : US
Telephone Number : 215-642-6600
Fax Number : 215-642-6610
Provider Business Practice Location Address
First Line : 5884 BRIDGETOWN RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-3106
Country : US
Telephone Number : 513-598-2965
Fax Number :
Authorized Official
Title or Position : COO
Name : CRAIG O MEHNERT
Credential :
Telephone Number : 215-642-6600
Provider Enumeration Date : 03/30/2017
Last Update Date : 03/30/2017

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