Provider Demographics
NPI:1598277618
Name:JEWISH FAMILY AND CHILDREN'S SERVICE
Entity Type:Organization
Organization Name:JEWISH FAMILY AND CHILDREN'S SERVICE
Other - Org Name:THE FIRST STEP ADDICTION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KORNFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-774-6886
Mailing Address - Street 1:705 SUMMERFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-6921
Mailing Address - Country:US
Mailing Address - Phone:732-774-6886
Mailing Address - Fax:732-774-8809
Practice Address - Street 1:705 SUMMERFIELD AVE
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-6921
Practice Address - Country:US
Practice Address - Phone:732-774-6886
Practice Address - Fax:732-774-8809
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JEWISH FAMILY AND CHILDREN'S SERVICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-30
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0283738Medicaid
NJ0283690Medicaid