NPIMap

Organization Active NPI

Active Ma, Inc.

  • Adult Day Care Clinic/Center
  • Mansfield, MA
National Provider Identifier
1316565757
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
ACTIVE MA, INC.
Doing business as
Active Day of Mansfield
Practice address
300 Branch St
Mansfield, MA 02048-2823
Phone
(508) 339-2119
NPI assigned
Jul 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Debora Hockenbury
Title
Contracts Manager
Phone
(215) 642-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary

Addresses

Primary practice location

300 Branch St
Mansfield, MA 02048-2823

Mailing address

6 Neshaminy Interplex Dr Ste 401
Trevose, PA 19053-6942
Phone (215) 642-6600

Other names 1

  • Active Day of Mansfield Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2109785Active Day of Mansfield300 Branch Street, Mansfield, MA 02048Certificate of waiverFeb 29, 2028

National Provider Directory

National Provider Directory
Tax ID family
Active Ma Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1316565757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 NESHAMINY INTERPLEX DR STE 401",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536942",
            "telephone_number": "215-642-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BRANCH ST",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020482823",
            "telephone_number": "508-339-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE MA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "HOCKENBURY",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_title_or_position": "CONTRACTS MANAGER",
        "authorized_official_telephone_number": "215-642-6600"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Day of Mansfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.