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General NPI Number Information
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NPI Number | 1104373331
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Entity Type | Organization
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Legal Business Name | THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF MARION COUNTY, OHIO
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Dates
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Enumeration Date | 09/06/2016
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Last Update Date | 09/06/2016
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Provider Practice Location Address
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Address Line | 645 BARKS RD E
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City | MARION
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State | OH
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Zip | 43302-6517
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Country | US
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Telephone | 740-725-9622
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Fax | 740-389-1287
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Provider Business Mailing Address
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Address Line | 645 BARKS RD E
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City | MARION
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State | OH
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Zip | 43302-6517
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Country | US
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Telephone | 740-725-9622
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Fax | 740-389-1287
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/CEO
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Name | THERESA LUBKE
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Credential |
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Telephone | 740-725-9622
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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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