| Youth Consultation Service Inc | |
|
20 E Evergreen Ave Somerdale NJ 08083-1402 | |
| (856) 309-5420 | |
| (856) 309-5435 |
| Full Name | Youth Consultation Service Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 20 E Evergreen Ave, Somerdale, 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 20 E Evergreen Ave Somerdale NJ 08083-1402 Ph: (856) 309-5420 |
| NPI Number | 1235315110 |
|---|---|
| Provider Enumeration Date | 01/10/2008 |
| Last Update Date | 01/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235315110 | NPI | - | NPPES |
| 0144681 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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