Organization
NORTHEAST TREATMENT CENTERS. INC.
Active
Organization
NORTHEAST TREATMENT CENTERS. INC.
Active
Other names
Northeast Treatment Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN NOEL (CHIEF FINANCIAL OFFICER)
(215) 451-7000
Entity
Organization
Contact information
Practice address
499 N 5TH ST, SUITE D-E, PHILADELPHIA, PA 19123-4005
(215) 451-7100
(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
261QM2800X
Methadone Clinic
910194
PA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
910194
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004972000
MAGELLAN PERSONAL CHOICE
PA
01
—
046410000
MAGELLAN COMMERCIAL
DE
01
—
046410000
MAGELLAN COMMERCIAL
PA
01
—
1000022246
DIAMOND STATE PARTNERS
DE
05
—
100022246
—
DE
05
—
100773886
—
PA
01
—
119254
COMMUNITY BEHAVIORAL HEAL
PA
01
—
119272
COMMUNTIY BEHAVIORAL HEAL
—
01
—
159997
BLUE CROSS DELAWARE
DE
01
—
217465
UNISON HEALTH PLAN
DE
01
—
273261
MANAGED HEALTH NETWORK
DE
01
—
273261
MANAGED HEALTH NETWORK
PA
01
—
296503000
MAGELLAN HEALTH CHOICES
PA
01
—
311749
MAGELLAN - KEYSTONE HPE
PA
01
—
462315000
MAGELLAN HEALTH CHOICES
PA
Enumeration date
02/05/2008
Last updated
06/19/2019
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