| Sarah Jack Services, Llc | |
|
256 Sherman Ave Teaneck NJ 07666-3311 | |
| (917) 636-7740 | |
| Not Available |
| Full Name | Sarah Jack Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 256 Sherman Ave, Teaneck, New Jersey |
| Authorized Official Name and Position | Sarah Jack (OWNER) |
| Authorized Official Contact | 9176367740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sarah Jack Services, Llc 256 Sherman Ave Teaneck NJ 07666-3311 Ph: (917) 636-7740 | Sarah Jack Services, Llc 256 Sherman Ave Teaneck NJ 07666-3311 Ph: (917) 636-7740 |
| NPI Number | 1164022083 |
|---|---|
| Provider Enumeration Date | 10/29/2020 |
| Last Update Date | 10/29/2020 |
| Certification Date | 10/29/2020 |
| Medicare PECOS PAC ID | 1052725199 |
|---|---|
| Medicare Enrollment ID | O20210201000467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164022083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sarah L Jack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104324490 PECOS PAC ID: 5092147041 Enrollment ID: I20191113003325 |
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