Provider Demographics
NPI:1639722358
Name:JEWEL HUMAN SERVICES, INC
Entity Type:Organization
Organization Name:JEWEL HUMAN SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRACEY-GOSINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-741-8495
Mailing Address - Street 1:12110 153RD ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-2324
Mailing Address - Country:US
Mailing Address - Phone:347-741-8495
Mailing Address - Fax:347-494-4150
Practice Address - Street 1:15231 134TH AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3528
Practice Address - Country:US
Practice Address - Phone:347-741-8495
Practice Address - Fax:347-494-4150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services