NPIMap

Organization Active NPI

Merakey Idd Philadelphia

  • Mental Illness Community Based Residential Treatment Facility
  • Philadelphia, PA
National Provider Identifier
1467635110
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
126430 Issued in PA
Legal business name
MERAKEY IDD PHILADELPHIA
Practice address
2991 W School House LN Apt C12E
Philadelphia, PA 19144-5350
Phone
(215) 844-2758
Fax
(215) 320-2041
NPI assigned
Dec 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Authorized official

Name
Mr. Norman E Tilson Jr.
Title
Corp Sr. Director of Business Ops
Phone
(215) 836-3131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 126430 PA Primary

Addresses

Primary practice location

2991 W School House LN Apt C12E
Philadelphia, PA 19144-5350

Mailing address

4700 Wissahickon Ave
Suite 100
Philadelphia, PA 19144-4248
Phone (215) 320-2040

Other names 1

  • The Association For Independent Growth, Inc Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Merakey Idd Philadelphia3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524096000000",
    "number": "1467635110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WISSAHICKON AVE",
            "address_2": "SUITE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444248",
            "telephone_number": "215-320-2040",
            "fax_number": "215-320-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2991 W SCHOOL HOUSE LN APT C12E",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191445350",
            "telephone_number": "215-844-2758",
            "fax_number": "215-320-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERAKEY IDD PHILADELPHIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2018-04-19",
        "status": "A",
        "authorized_official_last_name": "TILSON",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CORP SR. DIRECTOR OF BUSINESS OPS",
        "authorized_official_telephone_number": "215-836-3131",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "PA",
            "license": "126430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Association For Independent Growth, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "The Association For Independent Growth, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Apr 19, 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.