Organization
YOUTH CONSULTATION SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD MINGOIA (PRESIDENT AND CEO)
(973) 482-8411
Entity
Organization
Contact information
Practice address
101 E ATLANTIC AVE, HADDON HEIGHTS, NJ 08035-1901
(856) 672-0500
(856) 672-1114
Mailing address
284 BROADWAY, NEWARK, NJ 07104-4003
(973) 482-8411
(973) 482-5325
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
50019G44Y807
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8989508
—
NJ
Enumeration date
02/02/2007
Last updated
08/22/2020
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