Northeast Community Mental Health Center, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

105610 Issued in PA

Legal business name

NORTHEAST COMMUNITY MENTAL HEALTH CENTER, INC.

Practice address

2927 N 5TH St
2ND Floor
Philadelphia, PA 19133-2800

Phone

(215) 291-4357

Fax

(484) 221-9136

NPI assigned

Oct 3, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melissa Chlebowski

Title

Ceo

Phone

(484) 221-9136

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1043304199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 W TILGHMAN ST",
            "address_2": "SUITE 105B",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044354",
            "telephone_number": "484-221-9136",
            "fax_number": "484-221-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 N 5TH ST",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191332800",
            "telephone_number": "215-291-4357",
            "fax_number": "484-221-9136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST COMMUNITY MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "CHLEBOWSKI",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "484-221-9136"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "105610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BEHAVIORAL HEAL",
            "identifier": "1007295290004",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007295290004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northeast Community Center for Mental Health-Mental Retardation Inc.
• Northeast Community Center for MH/Mr
• Northeast Community Center for MH/Mr
• Northeast Community Center for MH/Mr
• Northeast Community Center for MH/Mr
• Northeast Community Mental Health Center, Inc.
• Northeast Community Mental Health Center, Inc.
• Northeast Dental Center, P.C.
• Northeast Discount
• Northeast Family Foot Care, PC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.