Organization
YOUTH CONSULTATION SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD MINGOIA (PRESIDENT CEO)
(973) 482-8411
Entity
Organization
Contact information
Practice address
16 HOLLYWOOD AVE, FARMINGDALE, NJ 07727-3833
(732) 919-2790
(732) 919-2794
Mailing address
284 BROADWAY, NEWARK, NJ 07104-4003
(973) 482-8411
(973) 482-2907
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
2720
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9027505
—
NJ
Enumeration date
02/06/2007
Last updated
08/22/2020
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