Provider Demographics
NPI:1235216722
Name:THE JEWISH BOARD OF FAMILY AND CHILDREN'S SERVICES
Entity Type:Organization
Organization Name:THE JEWISH BOARD OF FAMILY AND CHILDREN'S SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOC. EXECUTIVE DIRECTOR OF ADMIN.
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-582-9100
Mailing Address - Street 1:5601 14TH AVE APT 5E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4606
Mailing Address - Country:US
Mailing Address - Phone:718-871-9262
Mailing Address - Fax:
Practice Address - Street 1:2795 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5857
Practice Address - Country:US
Practice Address - Phone:718-761-9800
Practice Address - Fax:718-370-1142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074049-1251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW22701OtherMAGELLIN
NY00074049Medicaid