Acitve Day in, Inc.
Organization Active NPI Adult Day Care Clinic/Center · Fort Wayne, IN
NPI 1730628322 · NPPES record last updated Feb 16, 2017
Key facts
- NPI
- 1730628322
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Day Care Clinic/Center 261QA0600X
- Legal business name
- ACITVE DAY IN, INC.
- Practice address
- 3711 Rupp Dr
Suite 107
Fort Wayne, IN 46815-4523 - Phone
- (260) 484-2414
- NPI assigned
- Feb 16, 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 |
|---|---|---|---|
| 15D2150679 | Active Day of Fort Wayne | Certificate of waiver | Jun 28, 2028 |
National Provider Directory
- Tax ID family
- Active Day in Inc
- Part of
- Active Day Inc
Locations
3711 Rupp Dr
Ste 107
Fort Wayne, IN 46815
Phone (260) 484-2414
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | Yes |
Addresses
Primary practice location
3711 Rupp Dr
Suite 107
Fort Wayne, IN 46815-4523
Mailing address
6 Neshaminy Interplex
Suite 401
Trevose, PA 19053-6964
Phone (215) 642-6600
Other names
- Active Day of Fort Wayne
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All providers in Fort Wayne, IN · Adult Day Care Clinic/Center in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 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.