Provider Demographics
NPI:1841497492
Name:NEW HAVEN YOUTH & FAMILY SERVICES, INC
Entity type:Organization
Organization Name:NEW HAVEN YOUTH & FAMILY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-630-4035
Mailing Address - Street 1:PO BOX 1199
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92085-1199
Mailing Address - Country:US
Mailing Address - Phone:760-630-4065
Mailing Address - Fax:760-630-4067
Practice Address - Street 1:1126 N MELROSE DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-3467
Practice Address - Country:US
Practice Address - Phone:760-630-4065
Practice Address - Fax:760-630-4067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1336201490Medicare ID - Type Unspecified