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KIRKBRIDE CENTER
NPI 1558520841
Substance Abuse Rehabilitation Facility in Philadelphia, PA

Active since June 03, 2008CLIA 39D1004492 · Waiver
111 N 49TH ST, PHILADELPHIA, PA 19139(215) 471-2687(215) 471-2845 Get Directions Write a Review

NPPES record last updated: January 13, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 13, 2020, Jan 9, 2020 (2 updates tracked since 2020).

About Kirkbride Center NPPES

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

KIRKBRIDE CENTER (NPI 1558520841) is a healthcare organization registered as a substance abuse rehabilitation facility in Philadelphia, Pennsylvania and active in the NPI registry since June 2008. The organization holds a CLIA Waiver certificate valid through September 29, 2026 and lists Rose Diottavio, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1558520841
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameCORECARE BEHAVIORAL HEALTH MANAGEMENT, INC.
Location Address111 N 49TH STPhiladelphia, PA 19139-2718
Mailing Address111 N 49th StPhiladelphia, PA 19139-2718 · (215) 471-2687 · Fax (215) 471-2845
Phone(215) 471-2687
Fax(215) 471-2845
Organization SubpartNo
Authorized OfficialRose DiottavioPresident/ceo · (215) 471-2358
Enumeration DateJune 3, 2008
Last NPPES UpdateJanuary 13, 20202 updates tracked since enumeration
✔ NPI 1558520841 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
Also ListedSubstance Abuse Rehabilitation Facility · Substance Abuse Treatment, ChildrenTaxonomy 3245S0500X
111 N 49TH ST, Philadelphia, PA 19139
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Other Names 1

Doing Business AsKirkbride Center

Other Identifiers 1

Medicaid1007737600002PA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D1004492

Kirkbride Center · Philadelphia, PA
Active · expires Sep 29, 2026
CLIA Number39D1004492
Laboratory TypeHospital
Certificate Effective DateSeptember 30, 2024
Certificate Expiration DateSeptember 29, 2026
Laboratory DirectorDr. Frederic J. Weber
Laboratory Phone(215) 471-2600
Laboratory LocationKirkbride Center111 North 49th Street, Philadelphia, PA 19139
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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.

DR. SAMANTHA MEGAN WYCKOFF MD
Psychiatry & Neurology (Addiction Medicine)
111 N 49TH ST
PHILADELPHIA, PA 19139
Philadelphia County (215) 471-2600
PHILADELPHIA HEALTH MANAGEMENT CORP
Clinic/Center (Adult Mental Health)
111 N 49TH ST, 2ND FLOOR
PHILADELPHIA, PA 19139
Philadelphia County (215) 662-8881
CHARLES WALKER
Licensed Practical Nurse
111 N 49TH ST
PHILADELPHIA, PA 19139
Philadelphia County (215) 471-2866
ALLISON BOATRIGHT DNP, PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
111 N 49TH ST
PHILADELPHIA, PA 19139
Philadelphia County (215) 471-2600
ERICA M BRENDEL MD PC
Psychiatry & Neurology (Psychiatry)
111 N 49TH ST
PHILADELPHIA, PA 19139
Philadelphia County (215) 471-1576
MS. BELLA YAMPOLSKY PA-C
Physician Assistant (Medical)
111 N 49TH ST
PHILADELPHIA, PA 19139
Philadelphia County (215) 471-2131
MERCEDES JULIA DETTRA PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
111 N 49TH ST
PHILADELPHIA, PA 19139
Philadelphia County (215) 471-2600
IONA BARGE
Nurse Practitioner (Psychiatric/Mental Health)
111 N 49TH ST
PHILADELPHIA, PA 19139
Philadelphia County (214) 471-2600

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 Corecare Behavioral Health Management, Inc.'s NPI number?

The NPI number for Corecare Behavioral Health Management, Inc. is 1558520841. It was assigned to this organization in the NPPES registry on June 3, 2008. The provider is doing business as Kirkbride Center.

Where is Corecare Behavioral Health Management, Inc. located?

Corecare Behavioral Health Management, Inc. is located at 111 N 49th St, Philadelphia, PA 19139. The listed phone number is (215) 471-2687.

What is Corecare Behavioral Health Management, Inc.'s specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Corecare Behavioral Health Management, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D1004492) is associated with this NPI, valid through September 29, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Corecare Behavioral Health Management, Inc. was last updated on January 13, 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.