Provider Demographics
NPI:1639231012
Name:JEWISH FAMILY & CHILDRENS SERV
Entity type:Organization
Organization Name:JEWISH FAMILY & CHILDRENS SERV
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-838-1462
Mailing Address - Street 1:345 MONTGOMERY AVE REAR
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2801
Mailing Address - Country:US
Mailing Address - Phone:267-256-2100
Mailing Address - Fax:
Practice Address - Street 1:345 MONTGOMERY AVE REAR
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-2801
Practice Address - Country:US
Practice Address - Phone:267-256-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000008810019OtherDPW PDA WAIVER
PA1000008810009Medicaid
PA1000008810025OtherDEPT OF PUBLIC WELFARE
PA1000008810009Medicaid
PA696842Medicare PIN