NPIMap

Organization Active NPI

Northeast Community Center for Mental Health-Mental Retardation Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Philadelphia, PA
National Provider Identifier
1306210703
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
124560 Issued in PA
Legal business name
NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH-MENTAL RETARDATION INC.
Practice address
4641 Roosevelt Blvd
Orleans BLDG
Philadelphia, PA 19124-2343
Phone
(215) 831-2800
Fax
(215) 831-2929
NPI assigned
Nov 23, 2015
Last updated
Nov 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Authorized official

Name
David ComoNPI 1497991202
Title
Executive Director
Phone
(215) 831-2828

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
Mental Illness Community Based Residential Treatment Facility 320800000X 124560 PA Primary

Addresses

Primary practice location

4641 Roosevelt Blvd
Orleans BLDG
Philadelphia, PA 19124-2343

Mailing address

4641 Roosevelt Blvd
Orleans BLDG
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

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": "1448236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448236800000",
    "number": "1306210703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 ROOSEVELT BLVD",
            "address_2": "ORLEANS BLDG",
            "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",
            "address_2": "ORLEANS BLDG",
            "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": "2015-11-23",
        "last_updated": "2015-11-23",
        "status": "A",
        "authorized_official_last_name": "COMO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-831-2828"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "PA",
            "license": "124560",
            "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 Nov 23, 2015; 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.