Healthcare Provider Details

I. General information

NPI: 1982748331
Provider Name (Legal Business Name): ACTIVE DAY OH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1127 TOWNE ST
CINCINNATI OH
45216-2227
US

IV. Provider business mailing address

6 NESHAMINY INTERPLEX SUITE 401
TREVOSE PA
19053-6964
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-8000
  • 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 Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DEBORA HOCKENBURY
Title or Position: CONTRACTS MANAGER
Credential:
Phone: 215-642-6600