NPIMap

Organization Active NPI

Centralized Comprehensive Human Services, Inc.

Doing business as John F Kennedy Community MHMR Center

  • Case Management Agency
  • Philadelphia, PA
National Provider Identifier
1922121615
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
01186195 Issued in PA
Legal business name
CENTRALIZED COMPREHENSIVE HUMAN SERVICES, INC.
Doing business as
John F Kennedy Community MHMR Center
Practice address
112 N Broad St
Philadelphia, PA 19102-1510
Phone
(215) 568-0860
Fax
(215) 568-0769
NPI assigned
Apr 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Authorized official

Name
Alice G Young, MBA
Title
VP Finance
Phone
(215) 568-0860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 01186195 PA Primary

Addresses

Primary practice location

112 N Broad St
Philadelphia, PA 19102-1510

Mailing address

112 N Broad St
Philadelphia, PA 19102-1510
Phone (215) 568-0860

Other identifiers 1

IdentifierTypeStateIssuer
1000034530002MedicaidPA

Other names 1

  • John F Kennedy Community MHMR Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040114000697 PA Part B Supplier - Clinic/Group Practice 4284535196 Receives reassigned benefits from 6 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
John F Kennedy Community MHMR Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1922121615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021510",
            "telephone_number": "215-568-0860",
            "fax_number": "215-568-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021510",
            "telephone_number": "215-568-0860",
            "fax_number": "215-568-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRALIZED COMPREHENSIVE HUMAN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "215-568-0860",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "PA",
            "license": "01186195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000034530002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John F Kennedy Community MHMR Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.