MEDICARE: YOUTH ENVIRONMENTAL SERVICES, 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	251K00000X	Public Health or Welfare Agency	090111229	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215033139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUTH ENVIRONMENTAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	75 GRAND AVE
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-4905
Country	:	US
Telephone Number	:	516-799-3203
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 GRAND AVE
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-4905
Country	:	US
Telephone Number	:	516-799-3203
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ADRIENNE LOPRESTI
Credential	:	LCSW, R CASAC
Telephone Number	:	516-799-3203

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	12/09/2025

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