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General NPI Number Information
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NPI Number | 1104035518
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Entity Type | Organization
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Legal Business Name | GULF COAST JEWISH FAMILY AND COMMUNITY SERVICES, INC.
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 14041 ICOT BLVD
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City | CLEARWATER
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State | FL
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Zip | 33760-3702
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Country | US
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Telephone | 727-450-7269
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Fax | 727-479-1248
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Provider Business Mailing Address
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Address Line | 14041 ICOT BLVD
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City | CLEARWATER
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State | FL
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Zip | 33760-3702
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Country | US
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Telephone | 727-450-4269
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Fax | 727-479-1248
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Authorized Official
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Title or Position | CFO
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Name | CARLA WASHINKO
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Credential | CPA
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Telephone | 727-479-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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