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Organization

YOUTH CONSULTATION SERVICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICHARD MINGOIA (CEO)
(973) 482-8411
Entity
Organization

Contact information

Practice address
284 B ROADWAY, NEWARK, NJ 07104-4003
(973) 482-8411
(973) 482-2907
Mailing address
284 B ROADWAY, 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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0256714
NJ
Enumeration date
05/02/2011
Last updated
05/02/2011
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