Provider Demographics
NPI:1396360905
Name:THE TULSA JEWISH COMMUNITY RETIREMENT AND HEALTH CARE CENTER, INC.
Entity Type:Organization
Organization Name:THE TULSA JEWISH COMMUNITY RETIREMENT AND HEALTH CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:JAKUBOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-496-8333
Mailing Address - Street 1:2025 E 71ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-5407
Mailing Address - Country:US
Mailing Address - Phone:918-496-8333
Mailing Address - Fax:918-508-7032
Practice Address - Street 1:2025 E 71ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5407
Practice Address - Country:US
Practice Address - Phone:918-496-8333
Practice Address - Fax:918-508-7032
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE TULSA JEWISH COMMUNITY RETIREMENT AND HEALTH CARE CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty