Active NPI
Corecare Behavioral Health
Doing business as Kirkbride Center
- Psychiatric Hospital Unit
- Philadelphia, PA
National Provider Identifier
1851390561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital Unit
- License
- 197910
- Legal business name
- CORECARE BEHAVIORAL HEALTH
- Doing business as
- Kirkbride Center
- Practice address
- 111 N 49TH St
Philadelphia, PA 19139-2718 - Phone
- (215) 471-2488
- NPI assigned
- Jul 15, 2005
- 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
- Miss Rose S Diottavio
- Title
- President
- Phone
- (215) 471-2853
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | 197910 | PA | Primary |
| Rehabilitation Hospital Unit | 273Y00000X | 807208 | PA | |
| Substance Use Disorder Rehabilitation Hospital Unit | 276400000X | 807208 | PA | |
| Psychiatric Hospital | 283Q00000X |
Addresses
Primary practice location
111 N 49TH St
Philadelphia, PA 19139-2718
Mailing address
111 N 49TH St
Philadelphia, PA 19139-2718
Phone (215) 471-2488
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007737600004 | Medicaid | PA |
Other names 1
- Kirkbride Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Hospital certification: CCN 394007
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- KIRKBRIDE CENTER
- Certification status
- Terminated Voluntary: merger or closure, Feb 1, 2019
- Provider type (POS)
- Hospital – Psychiatric
- Participating since
- Jul 1, 1966
- Last certification
- Jan 26, 2011
- Beds
- 74
- Ownership / control type
- Private (not for profit)
- Facility address
- 111 N 49TH St
Philadelphia, PA 19139
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121385600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1445472000000",
"number": "1851390561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 N 49TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191392718",
"telephone_number": "215-471-2488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 N 49TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191392718",
"telephone_number": "215-471-2488"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CORECARE BEHAVIORAL HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2005-07-15",
"last_updated": "2015-10-22",
"status": "A",
"authorized_official_last_name": "DIOTTAVIO",
"authorized_official_first_name": "ROSE",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "215-471-2853",
"authorized_official_name_prefix": "Miss"
},
"taxonomies": [
{
"code": "273R00000X",
"taxonomy_group": "",
"desc": "Psychiatric Unit",
"state": "PA",
"license": "197910",
"primary": true
},
{
"code": "273Y00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Unit",
"state": "PA",
"license": "807208",
"primary": false
},
{
"code": "276400000X",
"taxonomy_group": "",
"desc": "Rehabilitation, Substance Use Disorder Unit",
"state": "PA",
"license": "807208",
"primary": false
},
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007737600004",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Kirkbride Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Philadelphia, PA
- Core Community Services LLC
- Core Performance and Rehabilitation
- Core Performance Physicians (Vincera Core Physicians)
- Core Performance Physicians, LLC (Vincera Core Physicians, LLC)
- Core Wellness Centers LLC
- Corecare Behavioral Health Management, Inc. (Kirkbride Center)
- Freda Coren, MD
- Gary Stephen Coren, MD
- Megumi Kondo Corley, DMD
- Eli Joseph Cornblath, MD, PHD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.