OrganizationActive
Northeast Community Center for Mh/Mr
NPI 1073882296 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Philadelphia, PA
Provider details
- NPI number
- 1073882296
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Howard Kaufman, Executive Director(215) 831-2800
- License
- 127450 (PA)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityPrimary320600000XLicense 127450 (PA)
Residential Treatment Facilities
Practice location
4641 Roosevelt Blvd
Orleans Building
Philadelphia, PA 19124-2343
Phone: (215) 831-2800
Approximate (ZIP-level) locationGet directions
Mailing address
4641 Roosevelt Blvd
Philadelphia, PA 19124-2343
Registry dates
- Enumerated
- 2011-12-16
- Last updated
- 2011-12-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.