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General NPI Number Information
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NPI Number | 1235271099
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Entity Type | Organization
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Legal Business Name | ACTIVE DAY MD, INC.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 12/05/2011
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Provider Practice Location Address
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Address Line | 354 MOUNTAIN RD SUITE G
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City | PASADENA
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State | MD
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Zip | 21122-1158
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Country | US
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Telephone | 410-255-2879
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Fax | 410-255-0905
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Provider Business Mailing Address
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Address Line | 7 NESHAMINY INTERPLEX DR SUITE 403
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City | TREVOSE
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State | PA
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Zip | 19053-6927
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Country | US
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Telephone | 215-642-6600
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Fax | 215-642-6610
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Authorized Official
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Title or Position | COO
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Name | CRAIG MEHNERT
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Credential |
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Telephone | 215-642-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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