Provider Demographics
NPI:1275385924
Name:JEWISH FAMILY AND CHILDREN'S SERVICE OF SOUTHERN ARIZONA, INC
Entity Type:Organization
Organization Name:JEWISH FAMILY AND CHILDREN'S SERVICE OF SOUTHERN ARIZONA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AND ACCOUNTING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KALI
Authorized Official - Middle Name:
Authorized Official - Last Name:NOUDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-795-0300
Mailing Address - Street 1:4301 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-2005
Mailing Address - Country:US
Mailing Address - Phone:520-795-0300
Mailing Address - Fax:
Practice Address - Street 1:4301 E 5TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2005
Practice Address - Country:US
Practice Address - Phone:520-795-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable