Provider Demographics
NPI:1750837159
Name:FAMILY AND YOUTH SERVICES
Entity Type:Organization
Organization Name:FAMILY AND YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LASANTA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:848-252-8625
Mailing Address - Street 1:330 MILLTOWN RD STE E22
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2287
Mailing Address - Country:US
Mailing Address - Phone:848-252-8625
Mailing Address - Fax:
Practice Address - Street 1:330 MILLTOWN RD STE E22
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2287
Practice Address - Country:US
Practice Address - Phone:848-252-8625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-27
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05444600251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health