| Youth Consultation Service Inc | |
|
60 Evergreen Pl Suite 309 East Orange NJ 07018-2106 | |
| (973) 854-3652 | |
| (973) 854-3653 |
| Full Name | Youth Consultation Service Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 60 Evergreen Pl, East Orange, 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 60 Evergreen Pl Suite 309 East Orange NJ 07018-2106 Ph: (973) 854-3652 |
| NPI Number | 1194849596 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194849596 | NPI | - | NPPES |
| 0123781 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 200167-06 (New Jersey) | Primary |
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