Provider Demographics
NPI:1760653042
Name:JEWISH FOUNDATION FOR GROUP HOMES
Entity Type:Organization
Organization Name:JEWISH FOUNDATION FOR GROUP HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIZEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-984-3839
Mailing Address - Street 1:1500 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1501
Mailing Address - Country:US
Mailing Address - Phone:301-984-3839
Mailing Address - Fax:301-576-5619
Practice Address - Street 1:912 DEVERE DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1622
Practice Address - Country:US
Practice Address - Phone:301-984-3839
Practice Address - Fax:301-576-5619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDDA-19977-07251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health