Provider Demographics
NPI:1114015211
Name:NEWTOWN YOUTH AND FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:NEWTOWN YOUTH AND FAMILY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-426-8103
Mailing Address - Street 1:15 BERKSHIRE RD.
Mailing Address - Street 2:NEWTOWN YOUTH AND FAMILY SERVICES
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482
Mailing Address - Country:US
Mailing Address - Phone:203-426-8103
Mailing Address - Fax:203-270-4338
Practice Address - Street 1:15 BERKSHIRE RD.
Practice Address - Street 2:NEWTOWN YOUTH AND FAMILY SERVICES
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482
Practice Address - Country:US
Practice Address - Phone:203-426-8103
Practice Address - Fax:203-270-4338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC-0254261QM0801X
CTOPCC-27261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTANC1319OtherOXFORD PROVIDER PIN
CT77ABH0020CT01OtherANTHEM BEHAVIORAL HEALTH
CT248294OtherMHN
CT00412586200Medicaid
CT00412586200Medicaid