Organization
NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH & MENTAL RETARDATION
Active
Organization
NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH & MENTAL RETARDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD J KAUFMAN (EXECUTIVE DIRECTOR)
(215) 831-2800
Entity
Organization
Contact information
Practice address
4641 ROOSEVELT BLVD, PHILADELPHIA, PA 19124-2343
(215) 831-2800
(215) 831-2929
Mailing address
4641 ROOSEVELT BLVD, PHILADELPHIA, PA 19124-2343
(215) 831-2800
(215) 831-2929
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
XRC190494
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000034170043
—
PA
Enumeration date
01/04/2007
Last updated
08/22/2020
Update your record
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