Healthcare Provider Details

I. General information

NPI: 1639627862
Provider Name (Legal Business Name): YOUNG MEN'S CHRISTIAN ASSOCIATION OF GREATER INDIANAPOLIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 09/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 S ALABAMA ST
INDIANAPOLIS IN
46225-3301
US

IV. Provider business mailing address

615 N ALABAMA ST SUITE 200
INDIANAPOLIS IN
46204-1430
US

V. Phone/Fax

Practice location:
  • Phone: 317-713-8548
  • Fax:
Mailing address:
  • Phone: 317-266-9622
  • Fax: 317-266-2845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JANET L ALLABY
Title or Position: SENIOR VICE PRESIDENT OF FINANCE
Credential:
Phone: 317-713-8530