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General NPI Number Information
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NPI Number | 1700418258
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Entity Type | Organization
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Legal Business Name | JEWISH FAMILY SERVICE ASSOCIATION
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Dates
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Enumeration Date | 02/12/2020
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 8132 CEDAR RD
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City | CHESTERLAND
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State | OH
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Zip | 44026-3548
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Country | US
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Telephone | 440-729-9406
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Fax |
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Provider Business Mailing Address
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Address Line | 29125 CHAGRIN BLVD
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City | PEPPER PIKE
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State | OH
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Zip | 44122-4622
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Country | US
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Telephone | 216-292-3999
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Fax |
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Authorized Official
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Title or Position | CIO
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Name | TIMOTHY JON WILLIAMS
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Credential |
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Telephone | 216-378-8669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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