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General NPI Number Information
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NPI Number | 1053436212
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Entity Type | Organization
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Legal Business Name | NORTHEAST TREATMENT CENTERS
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 2205 BRIDGE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19137-1313
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Country | US
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Telephone | 215-451-7000
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Fax | 215-451-7110
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Provider Business Mailing Address
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Address Line | 7520 STATE RD
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City | PHILADELPHIA
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State | PA
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Zip | 19136-3411
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Country | US
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Telephone | 215-451-7000
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Fax | 215-451-7110
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. WENDY WAIT
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Credential |
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Telephone | 215-451-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 910194
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License Number State | PA
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