Active Day in, Inc.
Organization Active NPI Adult Day Care Clinic/Center · Moline, IL
NPI 1508301433 · NPPES record last updated Jan 13, 2017
Key facts
- NPI
- 1508301433
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Day Care Clinic/Center 261QA0600X
- Legal business name
- ACTIVE DAY IN, INC.
- Practice address
- 4011 Avenue of the Cities
Suite 102
Moline, IL 61265-4454 - Phone
- (309) 797-0200
- NPI assigned
- Jan 2, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- ACTIVE DAY, INC.
Authorized official
- Name
- Craig O Mehnert
- Title
- Coo
- Phone
- (215) 642-6600
Corporate family (same tax ID) 17
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2165903 | Active Day of Moline | Certificate of waiver | May 6, 2027 |
National Provider Directory
- Tax ID family
- Active Day in Inc
- Part of
- Active Day Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| Adult Day Care Clinic/Center | 261QA0600X | Yes | ||
| Developmental Disabilities Clinic/Center | 261QD1600X |
Addresses
Primary practice location
4011 Avenue of the Cities
Suite 102
Moline, IL 61265-4454
Mailing address
6 Neshaminy Interplex
Suite 401
Trevose, PA 19053-6964
Phone (215) 642-6600
Other names
- Active Day of Moline
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- Courtney Adams
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All providers in Moline, IL · Adult Day Care Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.