MEDICARE: YOUNG ADULT INSTITUTE, 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	315P00000X	Intellectual Disabilities Intermediate Care Facility	7151440	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	:	1265601801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUNG ADULT INSTITUTE, INC.

Provider Business Mailing Address
First Line	:	460 W 34TH ST
Second Line	:	FL 11
City	:	NEW YORK
State	:	NY
Zip	:	10001-2382
Country	:	US
Telephone Number	:	212-273-6100
Fax Number	:	212-273-6406

Provider Business Practice Location Address
First Line	:	3079 HULL AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-4603
Country	:	US
Telephone Number	:	718-655-0907
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR ACCTS RECEIVABLE
Name	:	MR. ROBERT PITTI
Credential	:
Telephone Number	:	212-273-6625

Provider Enumeration Date	:	02/28/2008
Last Update Date	:	09/10/2008

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