# NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH & MENTAL RETARDATION

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

## Provider details

- **NPI number:** 1699822668
- **Authorized official:** HOWARD J KAUFMAN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (215) 831-2800

## Contact information

- **Practice address:** 7226 CASTOR AVE, PHILADELPHIA, PA 19149-1108
- **Practice address phone:** (215) 742-7810
- **Practice address fax:** (215) 742-7017
- **Mailing address:** 4641 ROOSEVELT BLVD, PHILADELPHIA, PA 19124-2343
- **Mailing address phone:** (215) 831-2800
- **Mailing address fax:** (215) 831-2929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 121890 | PA | Yes |

## Other

- **Enumeration date:** 01/04/2007
- **Last updated:** 08/22/2020