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General NPI Number Information
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NPI Number | 1770925992
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Entity Type | Organization
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Legal Business Name | NORTHEAST TREATMENT CENTERS, INC
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Dates
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Enumeration Date | 07/30/2013
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 1709 WASHINGTON AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19146-1913
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Country | US
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Telephone | 215-546-8060
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Fax | 215-925-6897
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Provider Business Mailing Address
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Address Line | 499 N 5TH ST SUITE A
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City | PHILADELPHIA
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State | PA
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Zip | 19123-4005
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Country | US
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Telephone | 215-451-7000
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Fax | 215-925-6897
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. ANNEMARIE STINSON
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Credential |
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Telephone | 215-451-7015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | 140040
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License Number State | PA
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