Healthcare Provider Details

I. General information

NPI: 1598277618
Provider Name (Legal Business Name): JEWISH FAMILY & CHILDRENS SERVICE OF GREATER MONMOUTH COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 SUMMERFIELD AVE
ASBURY PARK NJ
07712-6921
US

IV. Provider business mailing address

705 SUMMERFIELD AVE
ASBURY PARK NJ
07712-6921
US

V. Phone/Fax

Practice location:
  • Phone: 732-774-6886
  • Fax: 732-774-8809
Mailing address:
  • Phone: 732-774-6886
  • Fax: 732-774-8809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: LESLIE KORNFELD
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 732-774-6886