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
126 BUFFALO AVE UNIT 3, PATERSON, NJ 07503-1812
(973) 482-8411
(973) 482-2907
Mailing address
284 BROADWAY, NEWARK, NJ 07104-4003
(973) 482-8411
(973) 482-2907
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
SA488A
NJ
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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