Provider Demographics
NPI:1912092487
Name:JEWISH FAMILY SERVICE OF NASHVILLE AND MIDDLE TENNESSEE, INC.
Entity Type:Organization
Organization Name:JEWISH FAMILY SERVICE OF NASHVILLE AND MIDDLE TENNESSEE, INC.
Other - Org Name:JEWISH FAMILY SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:G
Authorized Official - Last Name:KELNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-354-1644
Mailing Address - Street 1:801 PERCY WARNER BLVD.
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-4218
Mailing Address - Country:US
Mailing Address - Phone:615-356-4234
Mailing Address - Fax:615-301-0676
Practice Address - Street 1:801 PERCY WARNER BLVD.
Practice Address - Street 2:SUITE 103
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-4218
Practice Address - Country:US
Practice Address - Phone:615-356-4234
Practice Address - Fax:615-301-0676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1041C0700X
TN780004424251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251K00000XAgenciesPublic Health or WelfareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3923232Medicare ID - Type Unspecified