Healthcare Provider Details

I. General information

NPI: 1740450543
Provider Name (Legal Business Name): JEWISH FAMILY SERVICES OF GREENWICH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2008
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 HOLLY HILL LN
GREENWICH CT
06830-6072
US

IV. Provider business mailing address

67 HOLLY HILL LN
GREENWICH CT
06830-6072
US

V. Phone/Fax

Practice location:
  • Phone: 203-622-1881
  • Fax: 855-672-0625
Mailing address:
  • Phone: 203-622-1881
  • Fax: 855-672-0625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: LISA L SMITH
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 203-622-1881