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
2033 SICKLERVILLE RD, SICKLERVILLE, NJ 08081-2427
(856) 232-6326
(856) 232-3172
Mailing address
284 BROADWAY, NEWARK, NJ 07104-4003
(973) 482-8411
(973) 482-2907
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
50019G44Y1107
NJ
323P00000X
Psychiatric Residential Treatment Facility
50019G44Y1207
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8989401
—
NJ
Enumeration date
02/05/2007
Last updated
06/06/2008
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