TRI COUNTY PASSAIC TEEN CENTER NPI 1972715142

NPI Information

NPI: 1972715142
Provider Name: TRI COUNTY PASSAIC TEEN CENTER

Other Name: TRI-COUNTY YOUTH SERVICES

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
228 HOPE AVENUE
PASSAIC, NJ
ZIP 07055
Phone: (973) 473-5755
Get Directions

TRI COUNTY PASSAIC TEEN CENTER is a residential treatment facility emotionally disturbed children in Passaic, NJ. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. TRI COUNTY PASSAIC TEEN CENTER NPI is 1972715142. The provider is registered as an organization entity type.
The provider Other Name Is Tri-county Youth Services.

The provider's business location address is:

228 HOPE AVENUE
PASSAIC, NJ
ZIP 07055
Phone: (973) 473-5755
Fax: (973) 470-8999

The provider's authorized official is Rasheed I Giles .
The authorized official title is Dirctor and has the following contact phone number (973) 473-5755.

The enumeration date for this NPI number is 5/3/2007 and was last updated on 7/10/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children			NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8373507	MEDICAID	NEW JERSEY
2	=========	OTHER	NEW JERSEY	TAX ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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