NPIMap

Organization Active NPI

Teen Challenge Training Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Philadelphia, PA
National Provider Identifier
1265933931
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
807166 Issued in PA
Legal business name
TEEN CHALLENGE TRAINING CENTER, INC.
Practice address
329 E Wister St
Philadelphia, PA 19144-1828
Phone
(215) 843-2887
NPI assigned
Feb 27, 2018
Last updated
Feb 27, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
TEEN CHALLENGE TRAINING CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Authorized official

Name
Bruce White
Title
Vice President, Finance
Phone
(717) 933-2804

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 807166 PA Primary

Addresses

Primary practice location

329 E Wister St
Philadelphia, PA 19144-1828

Mailing address

33 Teen Challenge Rd
Rehrersburg, PA 19550-5000
Phone (717) 933-2804

Other identifiers 1

IdentifierTypeStateIssuer
103149980-0003MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Teen Challenge Training Center Inc4 organizations share this tax ID, including this one
Part of
Teen Challenge Training Center Inc

Other organizations with this tax ID 3

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

Locations

329 E Wister St
Philadelphia, PA 19144
Phone (215) 843-2887

NPI Registry JSON

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519689600000",
    "number": "1265933931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 TEEN CHALLENGE RD",
            "city": "REHRERSBURG",
            "state": "PA",
            "postal_code": "195505000",
            "telephone_number": "717-933-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 E WISTER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191441828",
            "telephone_number": "215-843-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEEN CHALLENGE TRAINING CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TEEN CHALLENGE TRAINING CENTER, INC.",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-02-27",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VICE PRESIDENT, FINANCE",
        "authorized_official_telephone_number": "717-933-2804"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "807166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103149980-0003",
            "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 Feb 27, 2018; 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.