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NPI 1538758503

NPI 1538758503 : NEW HAVEN YOUTH & FAMILY SERVICES, INC : VISTA, CA

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General NPI Number Information
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    NPI Number           |    1538758503
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    Entity Type          |    Organization 
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    Legal Business Name  |    NEW HAVEN YOUTH & FAMILY SERVICES, INC 
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Dates
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    Enumeration Date     |    01/14/2021
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    Last Update Date     |    02/22/2021
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Provider Practice Location Address
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    Address Line         |    1032 MEADOW LAKE DR 
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    City                 |    VISTA
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    State                |    CA
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    Zip                  |    92084-4619
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    Country              |    US
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    Telephone            |    760-536-7937
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1199 
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    City                 |    VISTA
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    State                |    CA
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    Zip                  |    92085-1199
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    Country              |    US
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    Telephone            |    760-630-4035
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CHIEF EXECUTIVE OFFICER
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    Name                 |     DOREEN  QUINN 
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    Credential           |    
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    Telephone            |    760-505-6786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    
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    License Number State |    
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