Organization
NORTHEAST TREATMENT CENTERS, INC
Active
Other names
Northeast Treatment Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN P NOEL (CFO)
(215) 451-7159
Entity
Organization
Contact information
Practice address
499 N 5TH ST, SUITE A, PHILADELPHIA, PA 19123-4005
(215) 451-7000
(215) 925-6897
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
Primary
910194
PA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
910194
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004972000
PERSONAL CHOICE
PA
05
—
1000022246
—
DE
05
—
100022246
—
DE
05
—
1007738860039
—
PA
05
—
1007738860040
—
PA
01
—
159997
BLUE CROSS OF DELAWARE
DE
01
—
273261
MANAGED HEALTH NETWORK
DE
05
—
296503000
—
PA
01
—
311749
KEYSTONE HEALTH PLAN EAST
PA
05
—
462315000
—
PA
01
—
MAGELLAN
04641000
DE
01
—
MAGELLAN
046410000
PA
Enumeration date
03/19/2007
Last updated
07/24/2018
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