Healthcare Provider Details

I. General information

NPI: 1407399504
Provider Name (Legal Business Name): YOUNG MEN'S CHRISTIAN ASSOCIATION OF GREATER BOSTON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2016
Last Update Date: 11/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 HUNTINGTON AVE
BOSTON MA
02115-5019
US

IV. Provider business mailing address

316 HUNTINGTON AVE
BOSTON MA
02115-5019
US

V. Phone/Fax

Practice location:
  • Phone: 617-927-8040
  • Fax:
Mailing address:
  • Phone: 617-927-8040
  • Fax:

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. JAMES O'S. MORTON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: ESQ.
Phone: 671-927-8125