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NORTHEAST COMMUNITY CENTER FOR MH/MR
NPI 1073882296
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Philadelphia, PA

Active since December 16, 2011
4641 ROOSEVELT BLVD, ORLEANS BUILDING, PHILADELPHIA, PA 19124(215) 831-2800 Get Directions Write a Review

NPPES record last updated: December 16, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Northeast Community Center For Mh/mr NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHEAST COMMUNITY CENTER FOR MH/MR (NPI 1073882296) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Philadelphia, Pennsylvania and active in the NPI registry since December 2011. The organization lists Howard Kaufman, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1073882296
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameNORTHEAST COMMUNITY CENTER FOR MH/MR
Location Address4641 ROOSEVELT BLVD, ORLEANS BUILDINGPhiladelphia, PA 19124-2343
Mailing Address4641 Roosevelt Blvd, Orleans BuildingPhiladelphia, PA 19124-2343
Phone(215) 831-2800
Organization SubpartNo
Authorized OfficialHoward KaufmanExecutive Director · (215) 831-2800
Enumeration DateDecember 16, 2011
✔ NPI 1073882296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
License✔ Licensed in PA · 127450
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
4641 ROOSEVELT BLVD, Philadelphia, PA 19124
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Other Identifiers 3

Medicaid1000034170072PA
Medicaid1000034170061PA
Medicaid1000034170063PA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADAM LEVINE LCSW
Social Worker
4641 ROOSEVELT BLVD, ORLEANS BUILDING
PHILADELPHIA, PA 19124
Philadelphia County (215) 831-2899
FRIENDS BEHAVIORAL HEALTH SYSTEM, LP
Psychiatric Hospital
4641 ROOSEVELT BLVD
PHILADELPHIA, PA 19124
Philadelphia County (215) 831-4600
PAUL BALLAS
Psychiatry & Neurology (Psychiatry)
4641 ROOSEVELT BLVD
PHILADELPHIA, PA 19124
Philadelphia County (215) 831-7935
COURTNEY DOUDS LSW, MED
Social Worker
4641 ROOSEVELT BLVD
PHILADELPHIA, PA 19124
Philadelphia County (215) 831-2860
MR. JAMIYLAH SIKA BURNS PHYSICAL THERAPIST
Physical Therapist (Pediatrics)
4641 ROOSEVELT BLVD
PHILADELPHIA, PA 19124
Philadelphia County (215) 742-7820
CHRISTEN JOESELL YASSIN
Social Worker
4641 ROOSEVELT BLVD, ORLEANS BLDG
PHILADELPHIA, PA 19124
Philadelphia County (215) 831-2836
MRS. MARIANN MONTELEONE RN
Registered Nurse (Psychiatric/Mental Health)
4641 ROOSEVELT BLVD
PHILADELPHIA, PA 19124
Philadelphia County (215) 831-2964
DR. MITZIE L GRANT PHD.
Clinical Neuropsychologist
4641 ROOSEVELT BLVD, SUITE C229
PHILADELPHIA, PA 19124
Philadelphia County (215) 831-4811

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northeast Community Center For Mh/Mr's NPI number?

The NPI number for Northeast Community Center For Mh/Mr is 1073882296. It was assigned to this organization in the NPPES registry on December 16, 2011.

Where is Northeast Community Center For Mh/Mr located?

Northeast Community Center For Mh/Mr is located at 4641 Roosevelt Blvd Orleans Building, Philadelphia, PA 19124. The listed phone number is (215) 831-2800.

What is Northeast Community Center For Mh/Mr's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

When was this NPI record last updated?

The NPPES record for Northeast Community Center For Mh/Mr was last updated on December 16, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.