Provider Demographics
NPI:1457494106
Name:ACTIVE DAY FL, INC.
Entity Type:Organization
Organization Name:ACTIVE DAY FL, INC.
Other - Org Name:ACTIVE DAY OF BOYNTON BEACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN, CEO, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:BALDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-548-2201
Mailing Address - Street 1:400 REDLAND CT
Mailing Address - Street 2:SUITE 114
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3270
Mailing Address - Country:US
Mailing Address - Phone:443-548-2200
Mailing Address - Fax:443-548-2260
Practice Address - Street 1:4745 NW 7TH CT
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-9340
Practice Address - Country:US
Practice Address - Phone:561-547-2220
Practice Address - Fax:561-547-2279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care