NPIMap

Organization Active NPI

Intercommunity Action, Inc

  • Community/Behavioral Health Agency
  • Phila, PA
National Provider Identifier
1285778316
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
INTERCOMMUNITY ACTION, INC
Practice address
3500 Midvale Ave
Phila, PA 19129
Phone
(215) 487-1330
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
David Bolin
Title
Executive Director
Phone
(215) 487-0906

Specialties & licenses 1

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

Addresses

Primary practice location

3500 Midvale Ave
Phila, PA 19129

Mailing address

6012 Ridge Ave
Phila, PA 19128-1643
Phone (215) 487-0906

Other identifiers 1

IdentifierTypeStateIssuer
1000008360089MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Intercommunity Action Inc25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Locations

6012 Ridge Ave
Philadelphia, PA 19128
Phone (215) 487-0906

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1285778316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6012 RIDGE AVE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191281643",
            "telephone_number": "215-487-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 MIDVALE AVE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19129",
            "telephone_number": "215-487-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCOMMUNITY ACTION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "BOLIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-487-0906"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000008360089",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.