Provider Demographics
NPI:1790956225
Name:ACTIVE DAY IN, INC.
Entity Type:Organization
Organization Name:ACTIVE DAY IN, INC.
Other - Org Name:ACTIVE DAY OF DELAWARE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO, PRESIDENT/CHAIRMAN OF THE BOAR
Authorized Official - Prefix:MR
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:BALDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-548-2200
Mailing Address - Street 1:7701 W KILGORE AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:YORKTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47396-9290
Mailing Address - Country:US
Mailing Address - Phone:765-759-3851
Mailing Address - Fax:
Practice Address - Street 1:7701 W KILGORE AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:YORKTOWN
Practice Address - State:IN
Practice Address - Zip Code:47396-9290
Practice Address - Country:US
Practice Address - Phone:765-759-3851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACTIVE DAY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-12
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care