Provider Demographics
NPI:1679058010
Name:NORTHERN LIGHTS ACTIVE DAY CENTER.LLP
Entity type:Organization
Organization Name:NORTHERN LIGHTS ACTIVE DAY CENTER.LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FAISAL
Authorized Official - Middle Name:I
Authorized Official - Last Name:ADEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-822-1399
Mailing Address - Street 1:3551 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-2909
Mailing Address - Country:US
Mailing Address - Phone:614-822-1399
Mailing Address - Fax:
Practice Address - Street 1:3551 CLEVELAND AVE STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-2909
Practice Address - Country:US
Practice Address - Phone:614-822-1399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-02
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care