The Youth Success Network LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

64669006 Issued in NJ

Legal business name

THE YOUTH SUCCESS NETWORK LLC

Doing business as

Tysn

Practice address

375 Sylvan Ave
Suite 30
Englewood Cliffs, NJ 07632-2725

Phone

(201) 731-3739

Fax

(201) 731-3582

NPI assigned

Apr 18, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David Setsuo Ishibashi

Title

Executive Director

Phone

(551) 574-8739

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• TYSN Doing business as

Tax ID family

The Youth Success Network LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Youth Success Network LLC

  • Community/Behavioral Health Agency
  • North Brunswick, NJ
  • NPI 1689081309
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467331200000",
    "number": "1619193299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 SYLVAN AVE",
            "address_2": "SUITE 30",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322725",
            "telephone_number": "201-731-3739",
            "fax_number": "201-732-3582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 SYLVAN AVE",
            "address_2": "SUITE 30",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322725",
            "telephone_number": "201-731-3739",
            "fax_number": "201-731-3582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE YOUTH SUCCESS NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2016-07-01",
        "status": "A",
        "authorized_official_last_name": "ISHIBASHI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SETSUO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "551-574-8739",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NJ",
            "license": "64669006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030872",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TYSN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sylvie D Khorenian MD PC
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• Babita Tiwari, OTR/L
• Yogesh Tiwari, OTR/L
• Camila Torres
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• Michael James Triolo, MD

• Home Health Agency in Englewood Cliffs, NJ
• Providers in Englewood Cliffs, NJ by specialty
• Home Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.