House of Philadelphia, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

HOUSE OF PHILADELPHIA, INC.

Practice address

8571 Three Mile Rd
Irvington, AL 36544-3301

Phone

(251) 824-4689

Fax

(251) 824-1675

NPI assigned

Jan 19, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Mamie Hayden Mackey

Title

Executive Director

Phone

(251) 824-4689

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740333236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8571 THREE MILE RD",
            "city": "IRVINGTON",
            "state": "AL",
            "postal_code": "365443301",
            "telephone_number": "251-824-4689",
            "fax_number": "251-824-1675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8571 THREE MILE RD",
            "city": "IRVINGTON",
            "state": "AL",
            "postal_code": "365443301",
            "telephone_number": "251-824-4689",
            "fax_number": "251-824-1675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE OF PHILADELPHIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACKEY",
        "authorized_official_first_name": "MAMIE",
        "authorized_official_middle_name": "HAYDEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "251-824-4689",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylin Felice Goodwin, DPT
• Sonia Singh Grevenitis, M.D.
• Aayushka Gurung, MD
• Brittany Haberman, LPC
• Cheryl Berg Horn, M.S., CCC-SLP
• Eliceia Dionne Jackson, M.D.
• Kendra Marie Jones, LCSW/PIP
• Laboratory Corporation of America Holdings
• Addason Ladnier
• Kayleigh Jade Ladnier

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Irvington, AL
• Providers in Irvington, AL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.