Northeast Community Center For Mental Health-Mental Retardation I

LBN: Northeast Community Center For Mental Health-Mental Retardation I
Northeast Community Center For Mental Health-Mental Retardation I is an health care organization with primary practice located at 4641 Roosevelt Blvd , Philadelphia PA 19124-2343. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Ambulatory Health Care Facilities / Adult Mental Health is the primary health care specialty. Northeast Community Center For Mental Health-Mental Retardation I can be contacted via phone (215) 831-2800, or through Como, David via phone (215) 831-2800.

Contact Information

Primary practice address
4641 Roosevelt Blvd Philadelphia PA 19124-2343
Phone: (215) 831-2800
Fax: (215) 831-2929
Website:
Map and Directions
Authorized official contact:
Name: Como, David
Phone: (215) 831-2800

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X 121890 Pennsylvania
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X 121890 Pennsylvania

Profile Details

NPI number 1306907704
LBN Legal business name Northeast Community Center For Mental Health-Mental Retardation I
DBA Doing business as
Authorized official Como, David
Entity Organization
Organization subpart 1 No
Enumeration date Dec 12th, 2006
Last updated Jul 9th, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306907704 NPPES
Pennsylvania Other 769146 MEDICARE PTAN
Pennsylvania MEDICAID 1000034170051 MEDICARE PTAN
Pennsylvania Other 169773 MEDICARE PTAN

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