Healthcare Provider Details

I. General information

NPI: 1215483144
Provider Name (Legal Business Name): YOUNG MEN'S CHRISTIAN ASSOCIATION OF MUNCIE, INDIANA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S MULBERRY ST
MUNCIE IN
47305-2446
US

IV. Provider business mailing address

500 S MULBERRY ST
MUNCIE IN
47305-2446
US

V. Phone/Fax

Practice location:
  • Phone: 765-281-9622
  • Fax: 765-741-5555
Mailing address:
  • Phone: 765-281-9622
  • Fax: 765-741-5555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DEBBIE TODD
Title or Position: SENIOR VP OF FINANCE AND HR
Credential:
Phone: 765-741-5545