Basic Information
| Provider Information | |||||||||
| NPI: | 1801944178 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WESTCHESTER JEWISH COMMUNITY SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 845 N BROADWAY | ||||||||
| Address2: | |||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106032403 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 845 N BROADWAY | ||||||||
| Address2: | |||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106032403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147610600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | YELLEN | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | ASSISTANT EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9147610600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 01554585 | 05 | NY | MEDICAID |