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
—
—
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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