NPIMap

Organization Active NPI

Peer Drug and Alcohol Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Allentown, PA
National Provider Identifier
1710490438
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
397067 Issued in PA
Legal business name
PEER DRUG AND ALCOHOL PROGRAM
Doing business as
Peer Drug and Alcohol Program
Practice address
512 Hamilton St Ste 200
Allentown, PA 18101-1505
Phone
(267) 253-6588
Fax
(484) 221-9440
NPI assigned
Nov 16, 2017
Last updated
Feb 10, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
RAICES PASTORAL COUNSELING & HUMAN DEVELOPMENT CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Authorized official

Name
Erik Edgardo Juarez MendezNPI 1497311344
Title
Ceo
Phone
(267) 253-6588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 397067 PA Primary

Addresses

Primary practice location

512 Hamilton St Ste 200
Allentown, PA 18101-1505

Mailing address

512 Hamilton St Ste 200
Allentown, PA 18101-1505
Phone (267) 253-6588

Other names 1

  • PEER DRUG AND ALCOHOL PROGRAM Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Raices Pastoral Counseling and Human Development Center Inc2 organizations share this tax ID, including this one
Part of
Raices Pastoral Counseling and Human Development Center Inc

Other organizations with this tax ID 1

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.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1710490438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 HAMILTON ST STE 200",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181011505",
            "telephone_number": "267-253-6588",
            "fax_number": "484-221-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 HAMILTON ST STE 200",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181011505",
            "telephone_number": "267-253-6588",
            "fax_number": "484-221-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEER DRUG AND ALCOHOL PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RAICES PASTORAL COUNSELING &  HUMAN DEVELOPMENT CENTER",
        "enumeration_date": "2017-11-16",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "JUAREZ MENDEZ",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "EDGARDO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "267-253-6588"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "397067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEER DRUG AND ALCOHOL PROGRAM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.