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
20 E EVERGREEN AVE, SOMERDALE, NJ 08083-1402
(856) 309-5420
(856) 309-5435
Mailing address
284 BROADWAY, NEWARK, NJ 07104-4003
(973) 482-8411
(973) 482-2907
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0144681
—
NJ
Enumeration date
01/10/2008
Last updated
01/10/2008
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