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General NPI Number Information
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NPI Number | 1205378734
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Entity Type | Organization
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Legal Business Name | YOUNG MEN'S CHRISTIAN ASSOCIATION OF YOUNGSTOWN OH
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Dates
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Enumeration Date | 11/15/2016
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Last Update Date | 06/18/2018
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Provider Practice Location Address
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Address Line | 45 MCCLURG RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44512
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Country | US
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Telephone | 330-480-5656
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Fax | 330-259-9627
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Provider Business Mailing Address
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Address Line | 17 N CHAMPION ST P.O. BOX 1287
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City | YOUNGSTOWN
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State | OH
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Zip | 44503-1602
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Country | US
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Telephone | 330-744-8411
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Fax | 330-746-0068
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Authorized Official
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Title or Position | CEO
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Name | THOMAS M GACSE
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Credential |
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Telephone | 330-742-4799
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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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