Provider Demographics
NPI:1477125516
Name:THE HOUSE OF ISRAEL INC
Entity Type:Organization
Organization Name:THE HOUSE OF ISRAEL INC
Other - Org Name:THE HOUSE OF ISRAEL, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-712-2774
Mailing Address - Street 1:PO BOX 881
Mailing Address - Street 2:
Mailing Address - City:FORT MEADE
Mailing Address - State:FL
Mailing Address - Zip Code:33841-0881
Mailing Address - Country:US
Mailing Address - Phone:863-712-2774
Mailing Address - Fax:888-677-8750
Practice Address - Street 1:4 5TH ST SW
Practice Address - Street 2:
Practice Address - City:FORT MEADE
Practice Address - State:FL
Practice Address - Zip Code:33841-3410
Practice Address - Country:US
Practice Address - Phone:863-712-2774
Practice Address - Fax:888-677-8750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-16
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency CareGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility