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NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH-MENTAL RETARDATION I
NPI 1306907704
Clinic/Center - Adult Mental Health in Philadelphia, PA

Active since December 12, 2006
4641 ROOSEVELT BLVD, PHILADELPHIA, PA 19124(215) 831-2800(215) 831-2929 Get Directions Write a Review

NPPES record last updated: July 9, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Northeast Community Center For Mental Health-mental Retardation I NPPES

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

NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH-MENTAL RETARDATION I (NPI 1306907704) is a healthcare organization registered as an adult mental health in Philadelphia, Pennsylvania and active in the NPI registry since December 2006. The organization lists David Como, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1306907704
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NameNORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH-MENTAL RETARDATION I
Location Address4641 ROOSEVELT BLVDPhiladelphia, PA 19124-2343
Mailing Address4641 Roosevelt BlvdPhiladelphia, PA 19124-2343 · (215) 831-2800 · Fax (215) 831-2929
Phone(215) 831-2800
Fax(215) 831-2929
Organization SubpartNo
Authorized OfficialDavid ComoExecutive Director · (215) 831-2800
Enumeration DateDecember 12, 2006
Last NPPES UpdateJuly 9, 2014
✔ NPI 1306907704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
License✔ Licensed in PA · 121890
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X · License 121890 (PA)
4641 ROOSEVELT BLVD, Philadelphia, PA 19124
Open in Google Maps ↗

Other Identifiers 3

Other769146PA · Medicare Ptan
Other169773PA · Medicare Ptan
Medicaid1000034170051PA

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 Mental Health-Mental Retardation I's NPI number?

The NPI number for Northeast Community Center For Mental Health-Mental Retardation I is 1306907704. It was assigned to this organization in the NPPES registry on December 12, 2006.

Where is Northeast Community Center For Mental Health-Mental Retardation I located?

Northeast Community Center For Mental Health-Mental Retardation I is located at 4641 Roosevelt Blvd, Philadelphia, PA 19124. The listed phone number is (215) 831-2800.

What is Northeast Community Center For Mental Health-Mental Retardation I's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

When was this NPI record last updated?

The NPPES record for Northeast Community Center For Mental Health-Mental Retardation I was last updated on July 9, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.