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
1260 BLOOMFIELD AVE, FAIRFIELD, NJ 07004-3705
(973) 227-4458
(973) 227-4866
Mailing address
284 BROADWAY, NEWARK, NJ 07104-4003
(973) 482-8411
(973) 482-2907
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
4080
NJ
Other
Enumeration date
02/06/2007
Last updated
08/22/2020
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