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General NPI Number Information
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NPI Number | 1639231012
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Entity Type | Organization
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Legal Business Name | JEWISH FAMILY & CHILDRENS SERV
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 345 MONTGOMERY AVE REAR
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City | BALA CYNWYD
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State | PA
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Zip | 19004-2801
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Country | US
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Telephone | 267-256-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 345 MONTGOMERY AVE REAR
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City | BALA CYNWYD
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State | PA
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Zip | 19004-2801
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Country | US
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Telephone | 267-256-2100
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Fax |
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Authorized Official
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Title or Position | PROGRAM OFFICER
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Name | COURTNEY DIANE OWEN
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Credential |
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Telephone | 267-838-1462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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