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
260 UNION ST, HACKENSACK, NJ 07601-4203
(201) 343-8803
(201) 343-8563
Mailing address
284 BROADWAY, NEWARK, NJ 07104-4003
(973) 482-8411
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
50019G44Y107
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4989503
—
NJ
Enumeration date
02/06/2007
Last updated
09/22/2010
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