Organization
NORTHEAST TREATMENT CENTERS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN SOLOMONS (CHIEF FINANCIAL OFFICER)
(215) 451-7000
Entity
Organization
Contact information
Practice address
2701 N BROAD ST, PHILADELPHIA, PA 19132-2743
(215) 451-7000
(215) 451-7010
Mailing address
499 N 5TH ST, SUITE A, PHILADELPHIA, PA 19123-4005
(215) 451-7000
(215) 925-6897
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
807327
PA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
807327
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100773886
MAGELLAN HEALTH CHOICES
PA
05
—
100773886
—
PA
Enumeration date
04/01/2011
Last updated
07/03/2013
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