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THOMAS JEFFERSON UNIVERSITY NPI 1508011313


NPI Information

NPI: 1508011313
Provider Name: THOMAS JEFFERSON UNIVERSITY

Other Name: JEFFERSON UNIV - MATER FAMILY CENTER

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 39D2076389

Address:
1233 LOCUST ST
SUITE 201
PHILADELPHIA, PA
ZIP 19107
Phone: (215) 955-1952
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THOMAS JEFFERSON UNIVERSITY 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. THOMAS JEFFERSON UNIVERSITY NPI is 1508011313. The provider is registered as an organization entity type.
The provider Other Name Is Jefferson Univ - Mater Family Center.

The provider's business location address is:

1233 LOCUST ST
SUITE 201
PHILADELPHIA, PA
ZIP 19107-453
Phone: (215) 955-1952
Fax: (215) 568-6414

The provider's authorized official is Michelle Calvano .
The authorized official title is Business Manager and has the following contact phone number (215) 955-1952.

The CLIA number assigned to this NPI record is 39D2076389 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 11/20/2008 and was last updated on 6/14/2012.


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 HealthN8LT6601PENNSYLVANIAYes

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
11007571300104MEDICAIDPENNSYLVANIA

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

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