Provider Demographics
NPI:1740450543
Name:JEWISH FAMILY SERVICES OF GREENWICH INC
Entity type:Organization
Organization Name:JEWISH FAMILY SERVICES OF GREENWICH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-622-1881
Mailing Address - Street 1:67 HOLLY HILL LN
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6072
Mailing Address - Country:US
Mailing Address - Phone:203-622-1881
Mailing Address - Fax:855-672-0625
Practice Address - Street 1:67 HOLLY HILL LN
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6072
Practice Address - Country:US
Practice Address - Phone:203-622-1881
Practice Address - Fax:855-672-0625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251V00000XAgenciesVoluntary or CharitableGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCO2944OtherMEDICARE IDENTIFICATION#