| Northeast Community Center For Mental Health & Mental Retardation | |
|
7226 Castor Ave Philadelphia PA 19149-1108 | |
| (215) 742-7820 | |
| (215) 742-7808 |
| Full Name | Northeast Community Center For Mental Health & Mental Retardation |
|---|---|
| Speciality | Psychologist |
| Location | 7226 Castor Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Howard J Kaufman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2158312800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Community Center For Mental Health & Mental Retardation 4641 Roosevelt Blvd Philadelphia PA 19124-2343 Ph: (215) 831-2800 | Northeast Community Center For Mental Health & Mental Retardation 7226 Castor Ave Philadelphia PA 19149-1108 Ph: (215) 742-7820 |
| NPI Number | 1689723017 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689723017 | NPI | - | NPPES |
| 1000034170058 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 188220 (Pennsylvania) | Primary |
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