Healthcare Provider Details

I. General information

NPI: 1114413218
Provider Name (Legal Business Name): ACITVE DAY IN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 10/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 2ND AVE
TERRE HAUTE IN
47807-1435
US

IV. Provider business mailing address

6 NESHAMINY INTERPLEX SUITE 401
TREVOSE PA
19053-6964
US

V. Phone/Fax

Practice location:
  • Phone: 215-642-6600
  • 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

VIII. Authorized Official

Name: ROBERT CREAMER
Title or Position: CEO
Credential:
Phone: 215-642-6600