Provider Demographics
NPI:1538461744
Name:HOPE FOR YOUTH, INC.
Entity type:Organization
Organization Name:HOPE FOR YOUTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TESORO
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, LMSW
Authorized Official - Phone:631-782-6503
Mailing Address - Street 1:201 DIXON AVE
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2832
Mailing Address - Country:US
Mailing Address - Phone:631-691-5100
Mailing Address - Fax:691-691-5104
Practice Address - Street 1:201 DIXON AVE
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2832
Practice Address - Country:US
Practice Address - Phone:631-691-5100
Practice Address - Fax:691-691-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03225032Medicaid