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COMMUNITY COUNCIL FOR MH/MR NPI 1104008911


NPI Information

NPI: 1104008911
Provider Name: COMMUNITY COUNCIL FOR MH/MR
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
4900 WYALUSING AVE
PHILADELPHIA, PA
ZIP 19131
Phone: (215) 473-7033
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COMMUNITY COUNCIL FOR MH/MR is a community behavioral health in Philadelphia, PA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. COMMUNITY COUNCIL FOR MH/MR NPI is 1104008911. The provider is registered as an organization entity type.

The provider's business location address is:

4900 WYALUSING AVE
PHILADELPHIA, PA
ZIP 19131-127
Phone: (215) 473-7033
Fax: (215) 933-6926

The provider's authorized official is James Paige .
The authorized official title is Chief Information Officer and has the following contact phone number (215) 473-7033.

The enumeration date for this NPI number is 12/4/2007 and was last updated on 3/14/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral Health132640PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11000049601019MEDICAIDPENNSYLVANIA
2096047MEDICARE PINPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.