| Youth Consultation Service Inc | |
|
2 Road C Audubon NJ 08106-1822 | |
| (856) 310-9210 | |
| (856) 310-9212 |
| Full Name | Youth Consultation Service Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2 Road C, Audubon, New Jersey |
| Authorized Official Name and Position | Richard Mingoia (PRESIDENT CEO) |
| Authorized Official Contact | 9734828411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Consultation Service Inc 284 Broadway Newark NJ 07104-4003 Ph: (973) 482-8411 | Youth Consultation Service Inc 2 Road C Audubon NJ 08106-1822 Ph: (856) 310-9210 |
| NPI Number | 1437298080 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437298080 | NPI | - | NPPES |
| 8290504 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (New Jersey) | Primary |
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