NPIMap

Organization Active NPI

Merakey Parkside Recovery

  • Community/Behavioral Health Agency
  • Philadelphia, PA
National Provider Identifier
1104611201
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MERAKEY PARKSIDE RECOVERY
Practice address
7979 State Rd
Philadelphia, PA 19136-3407
Phone
(215) 836-3131
Fax
(215) 273-5975
NPI assigned
Apr 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Authorized official

Name
Mr. Norman E Tilson Jr.
Title
Corp Sr. Director of Bus Ops
Phone
(215) 836-3131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

7979 State Rd
Philadelphia, PA 19136-3407

Mailing address

620 Germantown Pike
Lafayette Hill, PA 19444-1810
Phone (215) 836-3131

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2341375Merakey Parkside Recovery7979 State Road, Philadelphia, PA 19136Certificate of waiverMar 31, 2028

National Provider Directory

National Provider Directory
Tax ID family
Merakey Parkside Recovery9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1744243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1104611201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 GERMANTOWN PIKE",
            "city": "LAFAYETTE HILL",
            "state": "PA",
            "postal_code": "194441810",
            "telephone_number": "215-836-3131",
            "fax_number": "215-273-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7979 STATE RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191363407",
            "telephone_number": "215-836-3131",
            "fax_number": "215-273-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERAKEY PARKSIDE RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-10",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "TILSON",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CORP SR. DIRECTOR OF BUS OPS",
        "authorized_official_telephone_number": "215-836-3131",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.