Provider Demographics
NPI:1184957037
Name:JEWISH CHILDCARE ASSOCIATION
Entity type:Organization
Organization Name:JEWISH CHILDCARE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-957-0019
Mailing Address - Street 1:44 COURT ST FL 5
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4417
Mailing Address - Country:US
Mailing Address - Phone:718-935-1791
Mailing Address - Fax:718-875-6613
Practice Address - Street 1:44 COURT ST FL 5
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4417
Practice Address - Country:US
Practice Address - Phone:718-935-1791
Practice Address - Fax:718-875-6613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075398251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY131624060Medicaid