NPIMap

Organization Active NPI

Place of Refuge, Inc

  • Community/Behavioral Health Agency
  • Philadelphia, PA
National Provider Identifier
1508051368
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
IN PROCESS Issued in PA
Legal business name
PLACE OF REFUGE, INC
Practice address
2938 N 5TH St
Philadelphia, PA 19133-2801
Phone
(267) 909-8550
Fax
(267) 909-8552
NPI assigned
Sep 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Authorized official

Name
Bryan Dickey
Title
Executive Director (Interim)
Phone
(267) 909-8550

Specialties & licenses 1

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

Addresses

Primary practice location

2938 N 5TH St
Philadelphia, PA 19133-2801

Mailing address

2938 N 5TH St
Philadelphia, PA 19133-2801
Phone (267) 909-8550

Other identifiers 1

IdentifierTypeStateIssuer
1022577860001MedicaidPA

Other names 1

  • The Place of Refuge Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260216001512 PA Part B Supplier - Clinic/Group Practice 2365922788 Receives reassigned benefits from 2 practitioners
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

2938 N 5th St
Philadelphia, PA 19133
Phone 2679098550 ext. 822

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1508051368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2938 N 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191332801",
            "telephone_number": "267-909-8550",
            "fax_number": "267-909-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2938 N 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191332801",
            "telephone_number": "267-909-8550",
            "fax_number": "267-909-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLACE OF REFUGE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "DICKEY",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR (INTERIM)",
        "authorized_official_telephone_number": "267-909-8550"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "IN PROCESS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022577860001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Place of Refuge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Place of Refuge",
            "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 Oct 3, 2024; 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.