Provider Demographics
NPI:1619785557
Name:EDEYOUTH INC
Entity type:Organization
Organization Name:EDEYOUTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARISTIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-601-9306
Mailing Address - Street 1:25344 147TH RD
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-2826
Mailing Address - Country:US
Mailing Address - Phone:917-601-9306
Mailing Address - Fax:
Practice Address - Street 1:14414 243RD ST
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-2328
Practice Address - Country:US
Practice Address - Phone:917-601-9306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable