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NPI Code Detail

MEDICARE: JEWISH FAMILY & CHILDREN'S SERVICE

MEDICARE: JEWISH FAMILY & CHILDREN'S SERVICE
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
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

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

General Provider Information

NPI Number : 1467520577
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEWISH FAMILY & CHILDREN'S SERVICE
Provider Business Mailing Address
First Line : 4747 N 7TH ST STE 100
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-3654
Country : US
Telephone Number : 602-279-7655
Fax Number : 602-253-8891
Provider Business Practice Location Address
First Line : 3001 N 33RD AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-5202
Country : US
Telephone Number : 602-353-0703
Fax Number : 602-353-0715
Authorized Official
Title or Position : PRESIDENT AND CEO
Name : DR. LORRIE HENDERSON
Credential : PHD, MBA, LCSW
Telephone Number : 602-279-7655
Provider Enumeration Date : 11/30/2006
Last Update Date : 07/18/2024

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Directions to “JEWISH FAMILY & CHILDREN'S SERVICE ” Practice Location

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