Active NPI
Northeast Treatment Centers, Inc
- Community/Behavioral Health Agency
- Philadelphia, PA
National Provider Identifier
1720102569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 910194
- Legal business name
- NORTHEAST TREATMENT CENTERS, INC
- Practice address
- 499 N 5TH St
Suite a
Philadelphia, PA 19123-4005 - Phone
- (215) 451-7000
- Fax
- (215) 925-6897
- NPI assigned
- Mar 19, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Kevin P Noel
- Title
- Cfo
- Phone
- (215) 451-7159
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 910194 | PA | Primary |
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | 910194 | PA |
Addresses
Primary practice location
499 N 5TH St
Suite a
Philadelphia, PA 19123-4005
Mailing address
499 N 5TH St
Suite a
Philadelphia, PA 19123-4005
Phone (215) 451-7000
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000022246 | Medicaid | DE | |
| 0004972000 | Other | PA | PERSONAL CHOICE |
| 296503000 | Medicaid | PA | |
| 1007738860039 | Medicaid | PA | |
| 100022246 | Medicaid | DE | |
| 159997 | Other | DE | BLUE CROSS OF DELAWARE |
| MAGELLAN | Other | DE | 04641000 |
| 462315000 | Medicaid | PA | |
| MAGELLAN | Other | PA | 046410000 |
| 1007738860040 | Medicaid | PA | |
| 273261 | Other | DE | MANAGED HEALTH NETWORK |
| 311749 | Other | PA | KEYSTONE HEALTH PLAN EAST |
Other names 1
- Northeast Treatment Centers
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1532390400000",
"number": "1720102569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "499 N 5TH ST",
"address_2": "SUITE A",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191234005",
"telephone_number": "215-451-7000",
"fax_number": "215-925-6897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "499 N 5TH ST",
"address_2": "SUITE A",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191234005",
"telephone_number": "215-451-7000",
"fax_number": "215-925-6897"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHEAST TREATMENT CENTERS, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-19",
"last_updated": "2018-07-24",
"status": "A",
"authorized_official_last_name": "NOEL",
"authorized_official_first_name": "KEVIN",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "215-451-7159",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "PA",
"license": "910194",
"primary": true
},
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": "PA",
"license": "910194",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1000022246",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL CHOICE",
"identifier": "0004972000",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "296503000",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007738860039",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100022246",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF DELAWARE",
"identifier": "159997",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "04641000",
"identifier": "MAGELLAN",
"state": "DE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "462315000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "046410000",
"identifier": "MAGELLAN",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007738860040",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "273261",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE HEALTH PLAN EAST",
"identifier": "311749",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Northeast Treatment Centers",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Philadelphia, PA
- Northeast Treatment Center, Inc
- Northeast Treatment Center, Inc
- Northeast Treatment Center, Inc.
- Northeast Treatment Centers
- Northeast Treatment Centers, Inc
- Northeast Treatment Centers, Inc
- Northeast Treatment Centers, Inc
- Northeast Treatment Centers, Inc.
- Northeast Treatment Centers. Inc.
- Northeast Treatment Centers.Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.