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General NPI Number Information
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NPI Number | 1821408741
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Entity Type | Organization
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Legal Business Name | JEWISH BOARD OF FAMILY AND CHILDREN'S SERVICES
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 04/30/2014
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Provider Practice Location Address
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Address Line | 135 W 50TH ST # 6
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City | NEW YORK
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State | NY
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Zip | 10020-1201
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Country | US
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Telephone | 212-582-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 135 W 50TH ST # 6
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City | NEW YORK
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State | NY
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Zip | 10020-1201
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Country | US
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Telephone | 212-582-9100
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Fax |
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Authorized Official
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Title or Position | ART THERAPIST
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Name | MELISSA DIAZ
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Credential | LCAT
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Telephone | 954-553-8827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number | 001756
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License Number State | NY
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