1063699635 NPI number — MEANINGFUL DAY SERVICES, INC

Table of content: (NPI 1063699635)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063699635 NPI number — MEANINGFUL DAY SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEANINGFUL DAY SERVICES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063699635
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/04/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 1110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROWNSBURG
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-858-8630
Provider Business Mailing Address Fax Number:
317-858-8715

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 S. SCHOOL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSBURG
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-858-8630
Provider Business Practice Location Address Fax Number:
317-858-8715
Provider Enumeration Date:
01/26/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MILLER-GIVAN
Authorized Official First Name:
SANDRA
Authorized Official Middle Name:
GALE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
317-858-8630

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200841060A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200317200A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".