Healthcare Provider Details

I. General information

NPI: 1407306277
Provider Name (Legal Business Name): YOUNG MEN'S CHRISTIAN ASSOCIATION OF METROPOLITAN ATLANTA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 10/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EDGEWOOD AVE NE SUITE 1100
ATLANTA GA
30303-3026
US

IV. Provider business mailing address

100 EDGEWOOD AVE NE SUITE 1100
ATLANTA GA
30303-3026
US

V. Phone/Fax

Practice location:
  • Phone: 404-588-9622
  • Fax: 404-527-7693
Mailing address:
  • Phone: 404-588-9622
  • Fax: 404-527-7693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. EDWARD G MUNSTER
Title or Position: CEO/PRESIDENT
Credential:
Phone: 404-527-7692