MEDICARE: YOUTH BECOMING ENGAGED INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1114886959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUTH BECOMING ENGAGED INC

Provider Business Mailing Address
First Line	:	85 CAROLINA AVE
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07106-2705
Country	:	US
Telephone Number	:	862-215-6627
Fax Number	:

Provider Business Practice Location Address
First Line	:	356 BLOOMFIELD AVE
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-3646
Country	:	US
Telephone Number	:	862-215-6627
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. LAMONT JAMES
Credential	:
Telephone Number	:	862-215-6627

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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