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General NPI Number Information
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NPI Number | 1881139715
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Entity Type | Organization
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Legal Business Name | ACTIVE DAY IN, INC.
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Dates
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Enumeration Date | 01/02/2017
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 1818 RIDGE RD #1 WEST
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City | HOMEWOOD
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State | IL
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Zip | 60430-1762
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Country | US
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Telephone | 708-957-4365
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Fax |
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Provider Business Mailing Address
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Address Line | 6 NESHAMINY INTERPLEX SUITE 401
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City | TREVOSE
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State | PA
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Zip | 19053-6964
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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 | MR. CRAIG O 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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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