NPIMap

Organization Active NPI

Penndel Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Penndel, PA
National Provider Identifier
1710019096
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PENNDEL MENTAL HEALTH CENTER, INC.
Practice address
1517 Durham Rd
Penndel, PA 19047-5707
Phone
(215) 752-1541
Fax
(215) 752-2848
NPI assigned
Mar 12, 2007
Last updated
Jun 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Authorized official

Name
Ms. Karen M Graff, M.ED.
Title
Executive Director
Phone
(267) 587-2300

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 123890 PA
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1517 Durham Rd
Penndel, PA 19047-5707

Mailing address

1723 Woodbourne Rd
Suite A110
Levittown, PA 19057-1510
Phone (267) 587-2300

Other identifiers 1

IdentifierTypeStateIssuer
100001996MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040609000667 PA Part B Supplier - Clinic/Group Practice 0042293300 Receives reassigned benefits from 32 practitioners
Practice locations: Penndel, PA

National Provider Directory

National Provider Directory
Tax ID family
Penndel Mental Health Center11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

2080 Cabot Blvd W
Ste 100
Langhorne, PA 19047
Phone (267) 587-2390

1723 Woodbourne Rd
Ste A110
Levittown, PA 19057
Phone (267) 587-2300

919 Durham Rd
Penndel, PA 19047
Phone (215) 750-7060

Practitioners & affiliated clinicians

Practitioners 176

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.

View all 176

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1710019096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 WOODBOURNE RD",
            "address_2": "SUITE A110",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "190571510",
            "telephone_number": "267-587-2300",
            "fax_number": "267-587-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 DURHAM RD",
            "city": "PENNDEL",
            "state": "PA",
            "postal_code": "190475707",
            "telephone_number": "215-752-1541",
            "fax_number": "215-752-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNDEL MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "GRAFF",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "267-587-2300",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.ED."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "PA",
            "license": "123890",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001996",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Penndel, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.