Healthcare Provider Details

I. General information

NPI: 1821165234
Provider Name (Legal Business Name): JEWISH FAMILY SERVICE OF ST. PAUL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1633 7TH ST W
SAINT PAUL MN
55102-4227
US

IV. Provider business mailing address

1633 - 7TH ST. W.
ST. PAUL MN
55102
US

V. Phone/Fax

Practice location:
  • Phone: 651-698-0767
  • Fax: 651-698-0162
Mailing address:
  • Phone: 651-698-0767
  • Fax: 651-698-0162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateMN

VIII. Authorized Official

Name: RENA WAXMAN
Title or Position: EXECUTIVE DIRECTOR
Credential: ACSW
Phone: 651-698-0767