NPIMap

Organization Active NPI

Centralized Comprehensive Human Services, Inc.

Doing business as John F Kennedy Behavioral Health Center

  • Community/Behavioral Health Agency
  • Philadelphia, PA
National Provider Identifier
1285756916
Registry record updated Mar 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
800284 Issued in PA
Legal business name
CENTRALIZED COMPREHENSIVE HUMAN SERVICES, INC.
Doing business as
John F Kennedy Behavioral Health Center
Practice address
907 N Broad St
Philadelphia, PA 19123-1013
Phone
(215) 568-0860
Fax
(215) 568-0769
NPI assigned
Apr 4, 2007
Last updated
Mar 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2012

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

Authorized official

Name
Alice G Young, MBA
Title
VP Finance
Phone
(215) 568-0860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 800284 PA Primary

Addresses

Primary practice location

907 N Broad St
Philadelphia, PA 19123-1013

Mailing address

112 N Broad St
Philadelphia, PA 19102-1510
Phone (215) 568-0860

Other identifiers 1

IdentifierTypeStateIssuer
1000034530021MedicaidPA

Other names 1

  • John F Kennedy Behavioral Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040114000697 PA Part B Supplier - Clinic/Group Practice 4284535196 Receives reassigned benefits from 6 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA
O20200218001867 PA Part B Supplier - Opioid Treatment Program (Otp) 4284535196 Practice locations: Philadelphia, PA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Robert P Bass Jr9 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.

Locations

2742 N 5th St
Philadelphia, PA 19133
Phone (215) 568-0622

907 N Broad St
Philadelphia, PA 19123
Phone (215) 235-5520

Practitioners & affiliated clinicians

Practitioners 5

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": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331856000000",
    "number": "1285756916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021510",
            "telephone_number": "215-568-0860",
            "fax_number": "215-568-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231013",
            "telephone_number": "215-568-0860",
            "fax_number": "215-568-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRALIZED COMPREHENSIVE HUMAN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2012-03-16",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "215-568-0860",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "800284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000034530021",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John F Kennedy Behavioral Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.