Provider Demographics
NPI:1649899485
Name:JUDAH GO GLOBAL FOUNDATION, LLC
Entity type:Organization
Organization Name:JUDAH GO GLOBAL FOUNDATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA, BA
Authorized Official - Phone:734-510-9972
Mailing Address - Street 1:4206 PACKARD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1525
Mailing Address - Country:US
Mailing Address - Phone:888-958-5640
Mailing Address - Fax:
Practice Address - Street 1:33 LABELLE ST APT 610
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:MI
Practice Address - Zip Code:48203-3687
Practice Address - Country:US
Practice Address - Phone:615-510-4160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-12
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No3418M1110XTransportation ServicesMilitary/U.S. Coast Guard TransportMilitary or U.S. Coast Guard Ambulance, Ground Transport
No251B00000XAgenciesCase Management
No251G00000XAgenciesHospice Care, Community Based
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No282NR1301XHospitalsGeneral Acute Care HospitalRural