COMMUNITY COUNCIL FOR MH/MR INC. NPI 1649377003

NPI Information

NPI: 1649377003
Provider Name: COMMUNITY COUNCIL FOR MH/MR, INC.
Classification: Clinic/Center - 261QC1500X
Entity Type: Organization

Specialization: Community Health

Address:
4900 WYALUSING AVE
PHILADELPHIA, PA
ZIP 19131
Phone: (215) 473-7033
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COMMUNITY COUNCIL FOR MH/MR, INC. is a community health clinic center in Philadelphia, PA. COMMUNITY COUNCIL FOR MH/MR, INC. NPI is 1649377003. 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) 473-5405

The provider's authorized official is Earle Bradford .
The authorized official title is Ceo and has the following contact phone number (215) 473-7033.

The enumeration date for this NPI number is 9/20/2006 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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QC1500X	Clinic/Center	Community Health	121630	PENNSYLVANIA	Yes

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

NPI Synchronization or Removal

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