Provider Demographics
NPI:1871691220
Name:GREENSBORO JEWISH FEDERATION
Entity Type:Organization
Organization Name:GREENSBORO JEWISH FEDERATION
Other - Org Name:JEWISH FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:FORMAN CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-852-5433
Mailing Address - Street 1:5509C W FRIENDLY AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-4211
Mailing Address - Country:US
Mailing Address - Phone:336-852-4829
Mailing Address - Fax:336-852-4346
Practice Address - Street 1:5509C W FRIENDLY AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4211
Practice Address - Country:US
Practice Address - Phone:336-852-4829
Practice Address - Fax:336-852-4346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC003902104100000X
251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251V00000XAgenciesVoluntary or Charitable
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC140N9OtherBCBS
NC140N9OtherBCBS