Provider Demographics
NPI:1689859209
Name:JEWISH BOARD OF FAMILY AND CHILDREN'S SERVICES, INC.
Entity Type:Organization
Organization Name:JEWISH BOARD OF FAMILY AND CHILDREN'S SERVICES, INC.
Other - Org Name:IRA
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF ACCOUNTS RECEIVABLE
Authorized Official - Prefix:MS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-773-7488
Mailing Address - Street 1:120 W 57TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3320
Mailing Address - Country:US
Mailing Address - Phone:212-582-9100
Mailing Address - Fax:
Practice Address - Street 1:120 W 57TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3320
Practice Address - Country:US
Practice Address - Phone:212-582-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02253414Medicaid