Healthcare Provider Details

I. General information

NPI: 1215711684
Provider Name (Legal Business Name): CAMBRIDGE YOUNG MEN'S CHRISTIAN ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 CLAIRMONT AVE
CAMBRIDGE OH
43725-1613
US

IV. Provider business mailing address

1301 CLAIRMONT AVE
CAMBRIDGE OH
43725-1613
US

V. Phone/Fax

Practice location:
  • Phone: 740-432-4600
  • Fax: 740-439-2598
Mailing address:
  • Phone: 740-432-4600
  • Fax: 740-439-2598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY MATTHEWS
Title or Position: MEMBERSHIP DIRECTOR
Credential:
Phone: 740-432-4600