Healthcare Provider Details

I. General information

NPI: 1881149862
Provider Name (Legal Business Name): THE ANN ARBOR YOUNG MEN'S CHRISTIAN ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 12/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W WASHINGTON ST
ANN ARBOR MI
48103-4230
US

IV. Provider business mailing address

400 W WASHINGTON ST
ANN ARBOR MI
48103-4230
US

V. Phone/Fax

Practice location:
  • Phone: 734-996-9622
  • Fax: 734-661-8060
Mailing address:
  • Phone: 734-996-9622
  • Fax: 734-661-8060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TONI KAYUMI
Title or Position: PRESIDENT/CEO
Credential:
Phone: 734-661-8059