| Youth Development Services, Llc | |
|
271 Standish Ave Hackensack NJ 07601-1716 | |
| (201) 543-3935 | |
| Not Available |
| Full Name | Youth Development Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 271 Standish Ave, Hackensack, New Jersey |
| Authorized Official Name and Position | Tara J Spates (AUTHORIZED MEMBER) |
| Authorized Official Contact | 9123891205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Development Services, Llc 6658 Sinkhole Rd Ambrose GA 31512-3890 Ph: (912) 389-1205 | Youth Development Services, Llc 271 Standish Ave Hackensack NJ 07601-1716 Ph: (201) 543-3935 |
| NPI Number | 1134327679 |
|---|---|
| Provider Enumeration Date | 07/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134327679 | NPI | - | NPPES |
| 0036587 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (New Jersey) | Primary |
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