Organization
YOUTH DEVELOPMENT SERVICES, LLC
Active
Organization
YOUTH DEVELOPMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA J SPATES (AUTHORIZED MEMBER)
(912) 389-1205
Entity
Organization
Contact information
Practice address
271 STANDISH AVE, HACKENSACK, NJ 07601-1716
(201) 543-3935
Mailing address
6658 SINKHOLE RD, AMBROSE, GA 31512-3890
(912) 389-1205
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0036587
—
NJ
Enumeration date
07/05/2007
Last updated
08/22/2020
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