Healthcare Provider Details

I. General information

NPI: 1528143146
Provider Name (Legal Business Name): JEWISH FAMILY AND CHILDREN'S SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10125 VERREE RD SUITE 304
PHILADELPHIA PA
19116-3611
US

IV. Provider business mailing address

10125 VERREE RD SUITE 304
PHILADELPHIA PA
19116-3611
US

V. Phone/Fax

Practice location:
  • Phone: 215-673-0100
  • Fax: 215-934-6284
Mailing address:
  • Phone: 215-673-0100
  • Fax: 215-934-6284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberCW015414
License Number StatePA

VIII. Authorized Official

Name: MR. HOWARD SITRON
Title or Position: EXECUTIVE VP; COO
Credential:
Phone: 215-496-9700