Provider Demographics
NPI:1629106794
Name:JEWISH FAMILY AND CHILDREN'S SERVICE
Entity Type:Organization
Organization Name:JEWISH FAMILY AND CHILDREN'S SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:STUESSY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:915-581-3256
Mailing Address - Street 1:401 WALLENBERG DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5605
Mailing Address - Country:US
Mailing Address - Phone:915-581-3256
Mailing Address - Fax:915-833-5743
Practice Address - Street 1:401 WALLENBERG DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5605
Practice Address - Country:US
Practice Address - Phone:915-581-3256
Practice Address - Fax:915-833-5743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0796252Medicaid