Provider Demographics
NPI:1255762597
Name:KENNEDY HEALTH SYSTEM
Entity type:Organization
Organization Name:KENNEDY HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFRIES
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:856-488-6514
Mailing Address - Street 1:2201 CHAPEL AVE W
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2048
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2201 CHAPEL AVE W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2048
Practice Address - Country:US
Practice Address - Phone:856-488-6514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit