East Park Revitalization Alliance

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

EAST PARK REVITALIZATION ALLIANCE

Practice address

1737 N 31St St
Philadelphia, PA 19121-2522

Phone

(610) 291-2481

NPI assigned

Mar 8, 2013

Organization subpart

No

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

Authorized official

Name

Suku John

Title

Executive Director

Phone

(610) 291-2481

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362700800000",
    "number": "1891036356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 N 31ST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191212522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 N 31ST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191212522",
            "telephone_number": "610-291-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PARK REVITALIZATION ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-08",
        "last_updated": "2013-03-08",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "SUKU",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "610-291-2481"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; 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.