Provider Demographics
NPI:1700159910
Name:YOUTH EDUCATION AND TRANSITION SERVICES INCORPORATED
Entity type:Organization
Organization Name:YOUTH EDUCATION AND TRANSITION SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, LPC, LCADC
Authorized Official - Phone:609-577-4310
Mailing Address - Street 1:141 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4248
Mailing Address - Country:US
Mailing Address - Phone:732-363-3038
Mailing Address - Fax:609-371-8481
Practice Address - Street 1:141 JOHN ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4248
Practice Address - Country:US
Practice Address - Phone:732-363-3038
Practice Address - Fax:609-371-8481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-18
Last Update Date:2012-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00117900251S00000X
NJ37PC00303500251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health