NPIMap

Organization Active NPI

Active Day in, Inc.

Doing business as Active Day of Moline

  • Adult Day Care Clinic/Center
  • Moline, IL
National Provider Identifier
1508301433
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
ACTIVE DAY IN, INC.
Doing business as
Active Day of Moline
Practice address
4011 Avenue of the Cities
Suite 102
Moline, IL 61265-4454
Phone
(309) 797-0200
NPI assigned
Jan 2, 2017
Last updated
Jan 13, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
ACTIVE DAY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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

Authorized official

Name
Craig O Mehnert
Title
Coo
Phone
(215) 642-6600

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
Adult Day Care Clinic/Center 261QA0600X Primary
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 1

  • Active Day of Moline 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
14D2165903Active Day of Moline4011 Avenue of the Cities - Ste 102, Moline, IL 61265Certificate of waiverMay 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Active Day in Inc18 organizations share this tax ID, including this one
Part of
Active Day

Other organizations with this tax ID 17

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

View all 17

Locations

4011 Avenue of the Cities
Ste 102
Moline, IL 61265
Phone (309) 797-0200

NPI Registry JSON

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

{
    "created_epoch": "1483315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484265600000",
    "number": "1508301433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 NESHAMINY INTERPLEX",
            "address_2": "SUITE 401",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536964",
            "telephone_number": "215-642-6600",
            "fax_number": "215-642-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 AVENUE OF THE CITIES",
            "address_2": "SUITE 102",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612654454",
            "telephone_number": "309-797-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE DAY IN, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACTIVE DAY, INC.",
        "enumeration_date": "2017-01-02",
        "last_updated": "2017-01-13",
        "status": "A",
        "authorized_official_last_name": "MEHNERT",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "215-642-6600"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Day of Moline",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.