NPIMap

Organization Active NPI

Northeast Community Center for Mental Health & Mental Retardation, Inc

  • Case Management Agency
  • Philadelphia, PA
National Provider Identifier
1215345301
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH & MENTAL RETARDATION, INC
Practice address
4641 Roosevelt Blvd
Philadelphia, PA 19124-2343
Phone
(215) 831-2800
Fax
(215) 831-2929
NPI assigned
Aug 1, 2014
Last updated
Aug 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Authorized official

Name
David Como, LCSWNPI 1497991202
Title
Executive Director
Phone
(215) 831-2800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

4641 Roosevelt Blvd
Philadelphia, PA 19124-2343

Mailing address

4641 Roosevelt Blvd
Philadelphia, PA 19124-2343
Phone (215) 831-2800

National Provider Directory

National Provider Directory
Tax ID family
Northeast Community Center for Mental Health Mental Retardation22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

4641 E Roosevelt Blvd
Philadelphia, PA 19124
Phone (215) 831-4600

Practitioners & affiliated clinicians

Practitioners 1

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": "1406851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406851200000",
    "number": "1215345301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242343",
            "telephone_number": "215-831-2800",
            "fax_number": "215-831-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242343",
            "telephone_number": "215-831-2800",
            "fax_number": "215-831-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH & MENTAL RETARDATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-01",
        "last_updated": "2014-08-01",
        "status": "A",
        "authorized_official_last_name": "COMO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-831-2800",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "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 Aug 1, 2014; 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.