Institute for the Developement of African American Youth

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

INSTITUTE FOR THE DEVELOPEMENT OF AFRICAN AMERICAN YOUTH

Practice address

1701 W Chelten Ave Ste 101a
Philadelphia, PA 19126-3410

Phone

(215) 276-5354

Fax

(215) 276-5357

NPI assigned

Oct 9, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Archye Leacock

Title

Executive Director

Phone

(215) 235-9116

Specialties & licenses 1

Addresses

Other names 1

• IDAAY Other name

Locations

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1518219922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2061",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191030061",
            "telephone_number": "215-235-9116",
            "fax_number": "215-235-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W CHELTEN AVE STE 101A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191263410",
            "telephone_number": "215-276-5354",
            "fax_number": "215-276-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE FOR THE DEVELOPEMENT OF AFRICAN AMERICAN YOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-09",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "LEACOCK",
        "authorized_official_first_name": "ARCHYE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-235-9116",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IDAAY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Case Management Agency in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Case Management Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.