MEDICARE: ACTIVE DAY OH, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1295186047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTIVE DAY OH, INC.

Provider Business Mailing Address
First Line	:	6 NESHAMINY INTERPLEX
Second Line	:	SUITE 401
City	:	TREVOSE
State	:	PA
Zip	:	19053-6964
Country	:	US
Telephone Number	:	215-642-6600
Fax Number	:	215-642-6610

Provider Business Practice Location Address
First Line	:	1208 W GALBRAITH RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-5608
Country	:	US
Telephone Number	:	513-894-3900
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	MR. CRAIG O MEHNERT
Credential	:
Telephone Number	:	215-642-6600

Provider Enumeration Date	:	06/23/2016
Last Update Date	:	06/23/2016

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