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General NPI Number Information
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NPI Number | 1174139091
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Entity Type | Organization
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Legal Business Name | ADOLPH AND ROSE LEVIS JEWISH COMMUNITY CENTER
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 9801 DONNA KLEIN BLVD
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City | BOCA RATON
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State | FL
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Zip | 33428-1755
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Country | US
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Telephone | 561-852-3200
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Fax | 561-852-5036
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Provider Business Mailing Address
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Address Line | 9801 DONNA KLEIN BLVD
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City | BOCA RATON
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State | FL
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Zip | 33428-1755
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Country | US
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Telephone | 561-852-3200
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Fax | 561-852-5036
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. MARTY HABERER
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Credential |
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Telephone | 561-852-3249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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