Northeast Community Center For Mental Health-Mental Retardation I in Philadelphia - Adolescent And Children Mental Health
Northeast Community Center For Mental Health-Mental Retardation I - NPI 1306907704
Northeast Community Center For Mental Health-Mental Retardation I is a Adolescent And Children Mental Health in Philadelphia, Pennsylvania. Northeast Community Center For Mental Health-Mental Retardation I practices all healthcare services and medical treatments related to Adolescent And Children Mental Health. The NPI Number for Northeast Community Center For Mental Health-Mental Retardation I is 1306907704. The last update date is 2014-07-09.
Northeast Community Center For Mental Health-Mental Retardation I's current location address is 4641 Roosevelt Blvd, Philadelphia, Pennsylvania. You can contact this provider via phone number 2158312800 and fax number 2158312929. The mailing address for Northeast Community Center For Mental Health-Mental Retardation I is 4641 Roosevelt Blvd, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Northeast Community Center For Mental Health-Mental Retardation I |
|---|---|
| Address | 4641 Roosevelt Blvd, Philadelphia, Pennsylvania |
| Phone Number | 2158312800 |
| Fax Number | 2158312929 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | EXECUTIVE |
|---|---|
| Authorized Official Name | Como David |
| Telephone Number | 2158312800 |
NPI Number Detail
| NPI Number | 1306907704 |
|---|---|
| Provider Enumeration Date | 2006-12-12 |
| Last Updated Date | 2014-07-09 |
Provider Mailing Address Detail
| Address | 4641 Roosevelt Blvd |
|---|---|
| City | Philadelphia |
| State | Pennsylvania (PA) |
| Post Code | 191242343 |
| Phone Number | 2158312800 |
| Fax Number | 2158312929 |
Provider's Primary Taxonomy Detail
| Speciality | Adolescent And Children Mental Health |
|---|---|
| Taxonomy | 261Qm0855X |
| Licence No | 121890 |
|
Definition: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patie |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 769146 | PA | MEDICARE PTAN | |
| 1000034170051 | PA | -- | |
| 169773 | PA | MEDICARE PTAN |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Northeast Community Center For Mental Health-Mental Retardation I by the Centers for Medicare & Medicaid Services?
The Northeast Community Center For Mental Health-Mental Retardation I has been issued the NPI (National Provider Identifier) 1306907704 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Northeast Community Center For Mental Health-Mental Retardation I's facilities are geographically located?
The facilities of Northeast Community Center For Mental Health-Mental Retardation I are physically situated at the following location: 4641 Roosevelt Blvd, Philadelphia, PA, 191242343.
What is Northeast Community Center For Mental Health-Mental Retardation I's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Northeast Community Center For Mental Health-Mental Retardation I's specialized field of practice is Adolescent And Children Mental Health, and the corresponding taxonomy code that categorizes this area of specialization is 261Qm0855X.
What is Northeast Community Center For Mental Health-Mental Retardation I's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Northeast Community Center For Mental Health-Mental Retardation I is Adolescent And Children Mental Health, and the taxonomy classification code that categorizes this area of expertise is 261Qm0855X.
On what date did Northeast Community Center For Mental Health-Mental Retardation I receive its 1306907704 assignment from the Centers for Medicare & Medicaid Services?
The Northeast Community Center For Mental Health-Mental Retardation I was assigned its 1306907704 on 2006-12-12, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.