Organization
YOUTH DEVELOPMENT SVCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REBECCA HENRIQUEZ LCSW (LCSW)
(201) 543-3935
Entity
Organization
Contact information
Practice address
12 N RTE 17, SUITE 313, PARAMUS, NJ 07652-2644
(201) 543-3935
(201) 226-1141
Mailing address
12 N RTE 17, SUITE 313, PARAMUS, NJ 07652-2644
(201) 543-3935
(201) 226-1141
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SC05258800
NJ
251E00000X
Home Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0036587
—
NJ
Enumeration date
12/22/2010
Last updated
10/02/2015
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