Organization
NORTHEAST TREATMENT CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WENDY WAIT (CHIEF FINANCIAL OFFICER)
(215) 451-7000
Entity
Organization
Contact information
Practice address
2205 BRIDGE ST, PHILADELPHIA, PA 19137-1313
(215) 451-7000
(215) 451-7110
Mailing address
7520 STATE RD, PHILADELPHIA, PA 19136-3411
(215) 451-7000
(215) 451-7110
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
910194
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004972000
MAGELLAN-PERSONAL CHOICE
PA
01
—
046410000
MAGELLAN-COMMERCIAL
PA
05
—
1007738860035
—
PA
01
—
159997
BLUE CROSS DELAWARE
PA
01
—
273261
MANAGED HLTH NETWORK
PA
01
—
311749
MAGELLAN-KEYSTONE HPE
PA
Enumeration date
03/20/2007
Last updated
01/28/2025
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