{"npi":"1730224445","type":"NPI-2","status":"active","name":{"display":"Intercommunity Action, INC","other":[],"organization_name":"INTERCOMMUNITY ACTION, INC","authorised_official":"David Bolin"},"specialty":{"primary_taxonomy":"251S00000X","primary_taxonomy_description":"Community/Behavioral Health Agency","slug":"community-behavioral-health-agency","schema_org_specialty":null,"all":[{"code":"251S00000X","description":"Community/Behavioral Health Agency","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"6122 RIDGE AVE","city":"PHILA","state":"PA","postal_code":"191281603","country_code":"US","phone":"2154871330"},{"purpose":"MAILING","street_1":"6012 RIDGE AVE","city":"PHILA","state":"PA","postal_code":"191281643","country_code":"US","phone":"2154870906"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"1000008360083","state":"PA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20040427000572","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"PA","pac_id":"2961499579"}]},"enumeration_date":"2007-02-20","last_updated":"2008-03-06","_meta":{"source":"NPPES","snapshot_date":"2008-03-06","doc_url":"https://findmynpi.com/api"}}