Healthcare Provider Details

I. General information

NPI: 1124952932
Provider Name (Legal Business Name): ACITVE DAY IN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 SHELBY ST
INDIANAPOLIS IN
46203-4260
US

IV. Provider business mailing address

6 INTERPLEX DR STE 401
TREVOSE PA
19053-6942
US

V. Phone/Fax

Practice location:
  • Phone: 317-296-8811
  • Fax:
Mailing address:
  • Phone: 215-642-6600
  • Fax:

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 Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SELENA DAWN DESHAZOR
Title or Position: MANAGER OF CONTRACTS AND LICENSING
Credential:
Phone: 215-642-6600