Provider Demographics
NPI:1538329487
Name:JEWISH BOARD OF FAMILY AND CHILDREN'S SERVICES
Entity Type:Organization
Organization Name:JEWISH BOARD OF FAMILY AND CHILDREN'S SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:JANEEN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:ARSHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:718-972-4820
Mailing Address - Street 1:1380 36TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3045
Mailing Address - Country:US
Mailing Address - Phone:718-972-4820
Mailing Address - Fax:718-854-5383
Practice Address - Street 1:1380 36TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3045
Practice Address - Country:US
Practice Address - Phone:718-972-4820
Practice Address - Fax:718-854-5383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6709431320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00244220Medicaid