Organization Name: | NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH-MENTAL RETARDATION INC. |
NPI Number: | 1396119798 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID COMO (EXECUTIVE DIRECTOR) |
Mailing Address: | 4641 Roosevelt Blvd Orleans Building Philadelphia |
State: | PA US |
Postal Code: | 191242343 |
Phone Number: | 2158312800 |
Fax Number: | 2158312929 |
NPI Enumeration Date: | 11/23/2015 |
NPI Last Update Date: | 11/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |