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General NPI Number Information
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NPI Number | 1033852413
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Entity Type | Organization
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Legal Business Name | MESABI FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 8367 UNITY DR
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City | VIRGINIA
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State | MN
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Zip | 55792-4005
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Country | US
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Telephone | 218-749-8020
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Fax |
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Provider Business Mailing Address
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Address Line | 8367 UNITY DR
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City | VIRGINIA
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State | MN
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Zip | 55792-4005
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Country | US
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Telephone | 218-749-8020
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Fax |
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Authorized Official
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Title or Position | LIFESTYLE COACH
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Name | KATHLEEN CINA
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Credential |
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Telephone | 218-741-7206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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