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General NPI Number Information
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NPI Number | 1629258157
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Entity Type | Organization
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Legal Business Name | JEWISH FAMILY & CHILDRENS SERVICE
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 3801 CONSHOHOCKEN AVE STE 123
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City | PHILADELPHIA
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State | PA
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Zip | 19131-5536
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Country | US
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Telephone | 215-878-2336
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Fax | 215-878-2379
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Provider Business Mailing Address
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Address Line | 2100 ARCH ST FL 5
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City | PHILADELPHIA
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State | PA
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Zip | 19103-1300
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Country | US
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Telephone | 215-496-9700
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Fax | 215-496-6622
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. SUSAN WYLAND
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Credential |
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Telephone | 215-496-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1041C0700X
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License Number State | PA
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