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Organization
JEWISH FAMILY SERVICE OF TIDEWATER, INCORPORATED
Active
Organization
JEWISH FAMILY SERVICE OF TIDEWATER, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA DENISE BENJAMIN CPA (CFO)
(757) 321-2247
Entity
Organization
Contact information
Practice address
5000 CORPORATE WOODS DR, SUITE 400, VIRGINIA BEACH, VA 23462-4429
(757) 321-2244
(757) 321-2260
Mailing address
5000 CORPORATE WOODS DR, SUITE 400, VIRGINIA BEACH, VA 23462-4429
(757) 321-2244
(757) 321-2260
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004974891
—
VA
05
—
008700435
—
VA
01
—
011608
ANTHEM BLUE CROSS BLUE SH
VA
Enumeration date
07/31/2006
Last updated
03/29/2021
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