Provider Demographics
NPI:1043579568
Name:JEWISH FAMILY SERVICE AGENCY
Entity Type:Organization
Organization Name:JEWISH FAMILY SERVICE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:702-732-0304
Mailing Address - Street 1:4794 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6145
Mailing Address - Country:US
Mailing Address - Phone:702-732-0304
Mailing Address - Fax:702-794-2033
Practice Address - Street 1:4794 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6145
Practice Address - Country:US
Practice Address - Phone:702-732-0304
Practice Address - Fax:702-794-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable