Provider Demographics
NPI:1205823853
Name:JEWISH FAMILY SERVICES, INC
Entity type:Organization
Organization Name:JEWISH FAMILY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:KETTERLINUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-282-5644
Mailing Address - Street 1:6718 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3419
Mailing Address - Country:US
Mailing Address - Phone:804-282-5644
Mailing Address - Fax:804-285-0006
Practice Address - Street 1:6718 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3419
Practice Address - Country:US
Practice Address - Phone:804-282-5644
Practice Address - Fax:804-285-0006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 103G00000X, 103TC0700X, 253Z00000X, 374U00000X, 1041C0700X
VA497554251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVA004974778Medicaid
VAVA008701709Medicaid
VAVA008772291Medicaid
VAVA497554Medicare Oscar/Certification