NPIMap

Organization Active NPI

Kensington Hospital- Intensive Outpatient Program

  • Methadone Clinic
  • Philadelphia, PA
National Provider Identifier
1336302017
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
807340 Issued in PA
Legal business name
KENSINGTON HOSPITAL- INTENSIVE OUTPATIENT PROGRAM
Practice address
136 Diamond St
Philadelphia, PA 19122-1721
Phone
(215) 426-8100
Fax
(215) 965-2344
NPI assigned
Jul 3, 2008
Organization subpart
Yes
Parent organization
KENSINGTON HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Ms. Eileen Hause, MBA
Title
Ceo
Phone
(215) 426-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X 807340 PA Primary

Addresses

Primary practice location

136 Diamond St
Philadelphia, PA 19122-1721

Mailing address

136 Diamond St
Philadelphia, PA 19122-1721
Phone (215) 426-8100

Other identifiers 1

IdentifierTypeStateIssuer
1007717290019MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Anesthesiology Kensingt13 organizations share this tax ID, including this one
Part of
Anesthesiology Kensingt

Other organizations with this tax ID 12

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1336302017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 DIAMOND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191221721",
            "telephone_number": "215-426-8100",
            "fax_number": "215-965-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 DIAMOND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191221721",
            "telephone_number": "215-426-8100",
            "fax_number": "215-965-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENSINGTON HOSPITAL- INTENSIVE OUTPATIENT PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENSINGTON HOSPITAL",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "HAUSE",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-426-8100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "PA",
            "license": "807340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007717290019",
            "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 Jul 3, 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.