MEDICARE: ACTIVE DAY IN, 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		IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447432638
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTIVE DAY IN, INC.

Provider Business Mailing Address
First Line	:	7 NESHAMINY INTERPLEX DR
Second Line	:
City	:	TREVOSE
State	:	PA
Zip	:	19053-6927
Country	:	US
Telephone Number	:	215-642-6600
Fax Number	:	215-642-6610

Provider Business Practice Location Address
First Line	:	9615 N COLLEGE AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46280-1627
Country	:	US
Telephone Number	:	317-569-0014
Fax Number	:	317-569-1364

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

Provider Enumeration Date	:	11/29/2007
Last Update Date	:	12/08/2011

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Directions to “ACTIVE DAY IN, INC. ” Practice Location

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