MEDICARE: WESTCHESTER JEWISH COMMUNITY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315P00000X	Intellectual Disabilities Intermediate Care Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205983707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTCHESTER JEWISH COMMUNITY SERVICES

Provider Business Mailing Address
First Line	:	845 N BROADWAY
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10603-2403
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	264 BRYANT AVE APT D
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-2106
Country	:	US
Telephone Number	:	914-949-5557
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT EXECUTIVE DIRECTOR
Name	:	STEVEN YELLEN
Credential	:	LMSW
Telephone Number	:	914-761-0600

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	08/22/2020

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