Healthcare Provider Details

I. General information

NPI: 1629294616
Provider Name (Legal Business Name): JEWISH COUNCIL FOR THE AGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 E JEFFERSON ST
ROCKVILLE MD
20852-4045
US

IV. Provider business mailing address

1801 E JEFFERSON ST
ROCKVILLE MD
20852-4045
US

V. Phone/Fax

Practice location:
  • Phone: 301-468-1740
  • Fax: 301-468-9207
Mailing address:
  • Phone: 301-468-1740
  • Fax: 301-468-9207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number16233
License Number StateMD

VIII. Authorized Official

Name: HELEN KAUFMAN
Title or Position: DIRECTOR
Credential:
Phone: 301-468-1740