Healthcare Provider Details

I. General information

NPI: 1336698216
Provider Name (Legal Business Name): YOUNG MEN'S CHRISTIAN ASSOCIATION OF METROPOLITAN WASHINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2016
Last Update Date: 10/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 16TH ST NW SUITE 720
WASHINGTON DC
20036-4823
US

IV. Provider business mailing address

1112 16TH ST NW SUITE 720
WASHINGTON DC
20036-4823
US

V. Phone/Fax

Practice location:
  • Phone: 202-232-6700
  • Fax: 202-232-9873
Mailing address:
  • Phone: 202-232-6700
  • Fax: 202-232-9873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANGIE REESE HAWKINS
Title or Position: CHIEF EXECUTIVE OFFICER/PRESIDENT
Credential:
Phone: 202-232-6700