Provider Demographics
NPI:1538758503
Name:NEW HAVEN YOUTH & FAMILY SERVICES, INC
Entity type:Organization
Organization Name:NEW HAVEN YOUTH & FAMILY SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-505-6786
Mailing Address - Street 1:PO BOX 1199
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92085-1199
Mailing Address - Country:US
Mailing Address - Phone:760-630-4035
Mailing Address - Fax:
Practice Address - Street 1:1032 MEADOW LAKE DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-4619
Practice Address - Country:US
Practice Address - Phone:760-536-7937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW HAVEN YOUTH & FAMILY SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-14
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health