NPIMap

Organization Active NPI

Active Ma, Inc.

  • Adult Day Care Clinic/Center
  • Weymouth, MA
National Provider Identifier
1629438676
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
ACTIVE MA, INC.
Practice address
370 Libbey Pkwy Ste 800
Weymouth, MA 02189-3179
Phone
(781) 749-1310
Fax
(781) 749-1360
NPI assigned
Mar 3, 2016
Last updated
Jan 25, 2018By 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 25, 2018

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X NU Primary
Respite Care 385H00000X NU

Addresses

Primary practice location

370 Libbey Pkwy Ste 800
Weymouth, MA 02189-3179

Mailing address

6 Neshaminy Interplex
Suite 401
Trevose, PA 19053-6964
Phone (215) 642-6600

Other identifiers 1

IdentifierTypeStateIssuer
110032728EMedicaidMA

National Provider Directory

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

Other organizations with this tax ID 12

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

Locations

370 Libbey Park
Ste 800
Weymouth, MA 02189
Phone (781) 749-1310

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1629438676",
    "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": "370 LIBBEY PKWY STE 800",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893179",
            "telephone_number": "781-749-1310",
            "fax_number": "781-749-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE MA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACTIVE DAY, INC.",
        "enumeration_date": "2016-03-03",
        "last_updated": "2018-01-25",
        "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": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110032728E",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.