Healthcare Provider Details

I. General information

NPI: 1013380294
Provider Name (Legal Business Name): HUNTERDON YOUTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2015
Last Update Date: 05/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 SAND HILL RD
FLEMINGTON NJ
08822-5582
US

IV. Provider business mailing address

56 SAND HILL RD P.O BOX 2397
FLEMINGTON NJ
08822-5582
US

V. Phone/Fax

Practice location:
  • Phone: 908-782-1046
  • Fax:
Mailing address:
  • Phone: 908-782-1046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. LAWRENCE BROOKS
Title or Position: EXECUTIVE DIRECTOR
Credential: MA, MS
Phone: 908-782-1046