Provider Demographics
NPI:1801925425
Name:JEWISH COMMUNITY HOMES FOR ADULT INDEPENDENCE
Entity type:Organization
Organization Name:JEWISH COMMUNITY HOMES FOR ADULT INDEPENDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:JARETT
Authorized Official - Last Name:LEVITAN
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:610-667-7875
Mailing Address - Street 1:21 BALA AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-3203
Mailing Address - Country:US
Mailing Address - Phone:610-667-7875
Mailing Address - Fax:610-667-7882
Practice Address - Street 1:21 BALA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3203
Practice Address - Country:US
Practice Address - Phone:610-667-7875
Practice Address - Fax:610-667-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities