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General NPI Number Information
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NPI Number | 1700159910
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Entity Type | Organization
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Legal Business Name | YOUTH EDUCATION AND TRANSITION SERVICES INCORPORATED
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Dates
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Enumeration Date | 02/18/2012
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Last Update Date | 02/18/2012
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Provider Practice Location Address
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Address Line | 141 JOHN ST
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4248
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Country | US
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Telephone | 732-363-3038
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Fax | 609-371-8481
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Provider Business Mailing Address
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Address Line | 141 JOHN ST
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4248
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Country | US
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Telephone | 732-363-3038
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Fax | 609-371-8481
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JEROME ROBINSON
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Credential | ED.S, LPC, LCADC
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Telephone | 609-577-4310
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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 | 37LC00117900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 37PC00303500
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License Number State | NJ
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