NPIMap

Organization Active NPI

Community Council for Mental Health and Mental Retardation I

  • Community/Behavioral Health Agency
  • Philadelphia, PA
National Provider Identifier
1972199032
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY COUNCIL FOR MENTAL HEALTH AND MENTAL RETARDATION I
Practice address
4900 Wyalusing Ave
Philadelphia, PA 19131-5127
Phone
(215) 921-3713
Fax
(215) 827-5276
NPI assigned
Dec 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Authorized official

Name
Rekiya Bell
Title
Director of Billing
Phone
(215) 921-3713

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4900 Wyalusing Ave
Philadelphia, PA 19131-5127

Mailing address

4900 Wyalusing Ave
Philadelphia, PA 19131-5127
Phone (215) 473-7033

Other identifiers 1

IdentifierTypeStateIssuer
146020MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Community Council36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1972199032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 WYALUSING AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191315127",
            "telephone_number": "215-473-7033",
            "fax_number": "215-827-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 WYALUSING AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191315127",
            "telephone_number": "215-921-3713",
            "fax_number": "215-827-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNCIL FOR MENTAL HEALTH AND MENTAL RETARDATION I",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "REKIYA",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "215-921-3713"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146020",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Dec 14, 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.