Provider Demographics
NPI:1124855838
Name:JEWISH FOUNDATION FOR GROUP HOMES
Entity type:Organization
Organization Name:JEWISH FOUNDATION FOR GROUP HOMES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIZEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-283-6013
Mailing Address - Street 1:1500 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1501
Mailing Address - Country:US
Mailing Address - Phone:240-283-6000
Mailing Address - Fax:
Practice Address - Street 1:1500 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1501
Practice Address - Country:US
Practice Address - Phone:240-283-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty