NPIMap

Organization Active NPI

Northeast Treatment Centers

  • Substance Abuse Rehabilitation Facility
  • Philadelphia, PA
National Provider Identifier
1053436212
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
910194 Issued in PA
Legal business name
NORTHEAST TREATMENT CENTERS
Practice address
2205 Bridge St
Philadelphia, PA 19137-1313
Phone
(215) 451-7000
Fax
(215) 451-7110
NPI assigned
Mar 20, 2007
Last updated
Jan 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Authorized official

Name
Mrs. Wendy Wait
Title
Chief Financial Officer
Phone
(215) 451-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 910194 PA Primary

Addresses

Primary practice location

2205 Bridge St
Philadelphia, PA 19137-1313

Mailing address

7520 State Rd
Philadelphia, PA 19136-3411
Phone (215) 451-7000

Other identifiers 6

IdentifierTypeStateIssuer
0004972000OtherPAMAGELLAN-PERSONAL CHOICE
159997OtherPABLUE CROSS DELAWARE
311749OtherPAMAGELLAN-KEYSTONE HPE
1007738860035MedicaidPA
046410000OtherPAMAGELLAN-COMMERCIAL
273261OtherPAMANAGED HLTH NETWORK

National Provider Directory

National Provider Directory
Tax ID family
Northeast Treatment Center Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1053436212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7520 STATE RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191363411",
            "telephone_number": "215-451-7000",
            "fax_number": "215-451-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 BRIDGE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191371313",
            "telephone_number": "215-451-7000",
            "fax_number": "215-451-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST TREATMENT CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "WAIT",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "215-451-7000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "910194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN-PERSONAL CHOICE",
            "identifier": "0004972000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS DELAWARE",
            "identifier": "159997",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN-KEYSTONE HPE",
            "identifier": "311749",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007738860035",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN-COMMERCIAL",
            "identifier": "046410000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HLTH NETWORK",
            "identifier": "273261",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.