Organization
GULF COAST JEWISH FAMILY AND COMMUNITY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORIS DIXON (CFO)
(727) 479-1800
Entity
Organization
Contact information
Practice address
2425 CHATLIN RD, HOLIDAY, FL 34691-3366
(727) 943-4847
(727) 479-1248
Mailing address
14041 ICOT BLVD, CLEARWATER, FL 33760-3702
(727) 450-7269
(727) 479-1248
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
430
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060569715
—
FL
Enumeration date
05/22/2007
Last updated
09/24/2018
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