# COMMUNITY COUNCIL FOR MH/MR, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649377003
- **Authorized official:** MR. ALEX MOORE (CEO)
- **Authorized official phone:** (215) 473-7033

## Contact information

- **Practice address:** 4900 WYALUSING AVE, PHILADELPHIA, PA 19131-5127
- **Practice address phone:** (215) 473-7033
- **Practice address fax:** (215) 473-5405
- **Mailing address:** 4900 WYALUSING AVE, PHILADELPHIA, PA 19131-5127
- **Mailing address phone:** (215) 921-3713
- **Mailing address fax:** (215) 827-5276

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | 121630 | PA | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 05/11/2026