Provider Demographics
NPI:1881952208
Name:SEACOAST YOUTH SERVICES
Entity type:Organization
Organization Name:SEACOAST YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MALONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-474-3332
Mailing Address - Street 1:867 LAFAYETTE RD
Mailing Address - Street 2:PO BOX 1381
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-4217
Mailing Address - Country:US
Mailing Address - Phone:603-474-3332
Mailing Address - Fax:603-372-0822
Practice Address - Street 1:867 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:NH
Practice Address - Zip Code:03874-4217
Practice Address - Country:US
Practice Address - Phone:603-474-3332
Practice Address - Fax:603-372-0822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency