Provider Demographics
NPI:1962671479
Name:YOUNG ADULT INSTITUTE, INC.
Entity Type:Organization
Organization Name:YOUNG ADULT INSTITUTE, INC.
Other - Org Name:YOUNG ADULT INST SHEEPSHEAD
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR ACCTS RECEIVABLE
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-273-6625
Mailing Address - Street 1:460 W 34TH ST
Mailing Address - Street 2:FL 11
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2382
Mailing Address - Country:US
Mailing Address - Phone:212-273-6100
Mailing Address - Fax:212-273-6406
Practice Address - Street 1:2657 E 13TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4402
Practice Address - Country:US
Practice Address - Phone:718-743-1983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YOUNG ADULT INSTITUTE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-28
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6113427315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01170947Medicaid