Organization
YOUTH CONSULTATION SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD MINGOIA (PRESIDENT CEO)
(973) 482-8411
Entity
Organization
Contact information
Practice address
711 32ND ST, SUITE 3, UNION CITY, NJ 07087-2418
(201) 865-8574
(201) 865-9419
Mailing address
284 BROADWAY, NEWARK, NJ 07104-4003
(973) 482-8411
(973) 482-2907
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0246557
—
NJ
Enumeration date
12/20/2010
Last updated
12/20/2010
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