NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH & MENTAL RETARDATION NPI 1306994694

NPI Information

NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH & MENTAL RETARDATION is an adult mental health clinic center in Philadelphia, PA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH & MENTAL RETARDATION NPI is 1306994694. The provider is registered as an organization entity type.

The provider's business location address is:

4641 ROOSEVELT BLVD
PHILADELPHIA, PA
ZIP 19124-343
Phone: (215) 831-2800
Fax: (215) 831-2929

The provider's authorized official is Howard J Kaufman .
The authorized official title is Executive Director and has the following contact phone number (215) 831-2800.

The enumeration date for this NPI number is 1/5/2007 and was last updated on 8/22/2020.

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:

Other Identifiers

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

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