Healthcare Provider Details

I. General information

NPI: 1518149707
Provider Name (Legal Business Name): ACTIVE DAY IN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7545 ROCKVILLE RD
INDIANAPOLIS IN
46214-3073
US

IV. Provider business mailing address

7 NESHAMINY INTERPLEX DR
TREVOSE PA
19053-6927
US

V. Phone/Fax

Practice location:
  • Phone: 317-271-2939
  • Fax: 317-271-1923
Mailing address:
  • Phone: 215-642-6600
  • Fax: 215-642-6600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateIN

VIII. Authorized Official

Name: MR. CRAIG MEHNERT
Title or Position: COO
Credential:
Phone: 215-642-6600