The Youth Success Network LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0397318 Issued in NJ

Legal business name

THE YOUTH SUCCESS NETWORK LLC

Practice address

1150 Newton St
Suite B
North Brunswick, NJ 08902-2286

Phone

(888) 897-6465

Fax

(877) 438-8976

NPI assigned

Jul 15, 2014

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

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

  • Home Health Agency
  • Englewood Cliffs, NJ
  • NPI 1619193299
  NPD tax ID

Locations

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405382400000",
    "number": "1689081309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 NEWTON ST",
            "address_2": "SUITE B.",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089022286",
            "telephone_number": "888-897-6465",
            "fax_number": "877-438-8976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 NEWTON ST",
            "address_2": "SUITE B",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089022286",
            "telephone_number": "888-897-6465",
            "fax_number": "877-438-8976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE YOUTH SUCCESS NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-15",
        "last_updated": "2014-07-15",
        "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": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "0397318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0397318",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sindhu Thogarchedu, LPC, BC-DMT, NCC
• Imogen Thomson, LAC
• Emily Jane Thornton, LMSW
• Stephen Tobia, PTA
• Irene Trakthman, DDS

• Community/Behavioral Health Agency in North Brunswick, NJ
• Providers in North Brunswick, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; 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.