Healthcare Provider Details

I. General information

NPI: 1952552234
Provider Name (Legal Business Name): ACTIVE DAY IN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2008
Last Update Date: 04/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5425 VICTORY DR
INDIANAPOLIS IN
46203-5954
US

IV. Provider business mailing address

6 NESHAMINY INTERPLEX DR SUITE 401
TREVOSE PA
19053-6964
US

V. Phone/Fax

Practice location:
  • Phone: 317-783-2155
  • Fax:
Mailing address:
  • Phone: 215-642-6600
  • Fax: 215-642-6610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateIN

VIII. Authorized Official

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