Provider Demographics
NPI:1730303272
Name:JEWISH FAMILY AND CHILDREN'S SERVICE OF GREATER PHILADELPHIA
Entity type:Organization
Organization Name:JEWISH FAMILY AND CHILDREN'S SERVICE OF GREATER PHILADELPHIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-496-9700
Mailing Address - Street 1:309 E MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MERCHANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-2621
Mailing Address - Country:US
Mailing Address - Phone:856-317-0706
Mailing Address - Fax:
Practice Address - Street 1:10125 VERREE RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-3611
Practice Address - Country:US
Practice Address - Phone:215-673-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1041C0700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty