Organization
YOUTH CONSULTATION SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD MINGOIA (PRESIDENT CEO)
(973) 482-8411
Entity
Organization
Contact information
Practice address
517 COOPER ST, CAMDEN, NJ 08102-1210
(856) 225-1250
(856) 225-1240
Mailing address
284 BROADWAY, NEWARK, NJ 07104-4003
(973) 482-8411
(973) 482-2907
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
GH1585
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0241946
—
NJ
Enumeration date
09/22/2010
Last updated
09/22/2010
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