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NPI Code Detail

MEDICARE: JEWISH BOARD OF FAMILY AND CHILDREN SERVICES

MEDICARE: JEWISH BOARD OF FAMILY AND CHILDREN SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320800000XMental Illness Community Based Residential Treatment Facility3980341NY

General Provider Information

NPI Number : 1295003838
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEWISH BOARD OF FAMILY AND CHILDREN SERVICES
Provider Business Mailing Address
First Line : 19 VEDDER AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-1509
Country : US
Telephone Number : 718-370-2975
Fax Number : 718-494-7836
Provider Business Practice Location Address
First Line : 19 VEDDER AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-1509
Country : US
Telephone Number : 718-370-2975
Fax Number : 718-494-7836
Authorized Official
Title or Position : PROGRAM DIRECTOR
Name : SHEILA CRISTINA SANTIAGO
Credential : LCSW
Telephone Number : 718-370-2975
Provider Enumeration Date : 12/11/2011
Last Update Date : 12/11/2011

Similar Medicare Providers

1487706792 — MS. SHEILA CRISTINA SANTIAGO LCSW
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Practice Fax: 718-494-7836
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1528345246 — MRS. CAROL ANN OTTESEN RN
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Practice Fax:
1467881912 — CANDACE MARIE SEAMAN LMSW
Practice Location Address:
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STATEN ISLAND, NY
10314-1509
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Practice Fax:
1124427877 — EMILY WILLSTATTER
Practice Location Address:
19 VEDDER AVE
STATEN ISLAND, NY
10314-1509
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Practice Fax:
1053833467 — ISAIAH BENNETT
Practice Location Address:
19 VEDDER AVE
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10314-1509
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Practice Fax:

Directions to “JEWISH BOARD OF FAMILY AND CHILDREN SERVICES ” Practice Location

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