Organization
YOUTH CONSULTATION SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP DEFALCO (SR VICE PRES/COO)
(973) 482-8411
Entity
Organization
Contact information
Practice address
284 BROADWAY, NEWARK, NJ 07104-4003
(973) 482-8411
Mailing address
284 BROADWAY, NEWARK, NJ 07104-4003
(973) 482-8411
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0532746
—
NJ
Enumeration date
10/24/2016
Last updated
04/11/2017
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