NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH & MENTAL RETARDATION
NPI 1336296706
Clinic/Center - Mental Health (Including Community Mental Health Center) in Philadelphia, PA

Q: What is Northeast Community Center For Mental Health & Mental Retardation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Active since January 05, 2007

4641 ROOSEVELT BLVD, PHILADELPHIA, PA 19124(215) 831-2800(215) 831-2929 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Northeast Community Center For Mental Health & Mental Retardation NPPES

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

NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH & MENTAL RETARDATION (NPI 1336296706) is a healthcare organization registered as a mental health (including community mental health center) in Philadelphia, Pennsylvania and active in the NPI registry since January 2007. The organization lists Howard J Kaufman, Executive Direcotr, as its authorized official.

NPPES Registry Identity

NPI1336296706

Entity TypeOrganization

Primary Taxonomy261QM0801X

Legal Business NameNORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH & MENTAL RETARDATION

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 OfficialHoward J KaufmanExecutive Direcotr · (215) 831-2800

Enumeration DateJanuary 5, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1336296706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities

Taxonomy Code261QM0801X

License✔ Licensed in PA · 121920

4641 ROOSEVELT BLVD, Philadelphia, PA 19124

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Other Identifiers 1

Medicaid1000034170037PA

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's NPI number?

The NPI number for Northeast Community Center For Mental Health & Mental Retardation is 1336296706. It was assigned to this organization in the NPPES registry on January 5, 2007.

Where is Northeast Community Center For Mental Health & Mental Retardation located?

Northeast Community Center For Mental Health & Mental Retardation 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's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Northeast Community Center For Mental Health & Mental Retardation was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.