Provider Demographics
NPI:1700290962
Name:NEW DIRECTIONS FOR YOUNG ADULTS - CALIFORNIA
Entity Type:Organization
Organization Name:NEW DIRECTIONS FOR YOUNG ADULTS - CALIFORNIA
Other - Org Name:NDFYA-CA
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:SETH
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-778-7808
Mailing Address - Street 1:3275 W. HILLSBORO BLVD
Mailing Address - Street 2:STE. 110
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442
Mailing Address - Country:US
Mailing Address - Phone:954-571-5102
Mailing Address - Fax:954-571-5265
Practice Address - Street 1:100 LONGBROOK WAY
Practice Address - Street 2:STE. 20
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523
Practice Address - Country:US
Practice Address - Phone:877-763-5102
Practice Address - Fax:954-571-5265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 15497103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty