Provider Demographics
NPI:1609410117
Name:YOUNG MINDS EARLY ENRICHMENT
Entity Type:Organization
Organization Name:YOUNG MINDS EARLY ENRICHMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALYAR
Authorized Official - Suffix:
Authorized Official - Credentials:MS SP ED
Authorized Official - Phone:718-356-8888
Mailing Address - Street 1:143 WIMAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308
Mailing Address - Country:US
Mailing Address - Phone:718-356-8888
Mailing Address - Fax:
Practice Address - Street 1:143 WIMAN AVENUE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308
Practice Address - Country:US
Practice Address - Phone:718-356-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency