Provider Demographics
NPI:1598758179
Name:JEWISH FAMILY SERVICE OF THE DESERT
Entity Type:Organization
Organization Name:JEWISH FAMILY SERVICE OF THE DESERT
Other - Org Name:JEWISH FAMILY SERVICE OF THE DESERT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-325-4088
Mailing Address - Street 1:490 S FARRELL DR
Mailing Address - Street 2:SUITE C 208
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-7992
Mailing Address - Country:US
Mailing Address - Phone:760-325-4088
Mailing Address - Fax:760-778-3781
Practice Address - Street 1:490 S FARRELL DR
Practice Address - Street 2:SUITE C 208
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-7992
Practice Address - Country:US
Practice Address - Phone:760-325-4088
Practice Address - Fax:760-778-3781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-29
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)