Organization
THE YOUTH SUCCESS NETWORK LLC
Active
Other names
TYSN
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID SETSUO ISHIBASHI (EXECUTIVE DIRECTOR)
(551) 574-8739
Entity
Organization
Contact information
Practice address
375 SYLVAN AVE, SUITE 30, ENGLEWOOD CLIFFS, NJ 07632-2725
(201) 731-3739
(201) 731-3582
Mailing address
375 SYLVAN AVE, SUITE 30, ENGLEWOOD CLIFFS, NJ 07632-2725
(201) 731-3739
(201) 732-3582
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
64669006
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030872
—
NJ
Enumeration date
04/18/2007
Last updated
07/01/2016
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