Healthcare Provider Details

I. General information

NPI: 1588673347
Provider Name (Legal Business Name): JEWISH FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1165 N MAIN ST
PROVIDENCE RI
02904-5740
US

IV. Provider business mailing address

1165 N MAIN ST
PROVIDENCE RI
02904-5740
US

V. Phone/Fax

Practice location:
  • Phone: 401-331-1244
  • Fax: 401-331-5772
Mailing address:
  • Phone: 401-331-1244
  • Fax: 401-331-5772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MERELISE A HITTE
Title or Position: CFO
Credential:
Phone: 401-331-1244