Organization
GULF COAST JEWISH FAMILY AND COMMUNITY SERVICES, INC
Active
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
14041 ICOT BLVD, CLEARWATER, FL 33760-3702
(727) 479-1800
(727) 479-1248
Mailing address
14041 ICOT BLVD, CLEARWATER, FL 33760-3702
(727) 479-1800
(727) 479-1248
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029915401
MEDICAID - CM HILLSBOR
FL
05
—
060569700
MEDICAID - CMH PINELLAS
FL
05
—
060569701
MEDICAID - CM PINELLAS
FL
05
—
060569703
MEDICAID - BROWARD
FL
05
—
060569705
—
FL
05
—
060569710
MEDICAID - DARLINGTON
FL
05
—
060569715
—
FL
05
—
6356700
—
FL
Enumeration date
07/19/2007
Last updated
09/24/2018
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