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General NPI Number Information
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NPI Number | 1215488531
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Entity Type | Organization
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Legal Business Name | THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF EAU CLAIRE WISCONSIN
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Dates
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Enumeration Date | 10/21/2016
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Last Update Date | 10/21/2016
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Provider Practice Location Address
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Address Line | 700 GRAHAM AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-3840
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Country | US
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Telephone | 715-836-8460
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Fax | 715-836-8467
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Provider Business Mailing Address
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Address Line | 700 GRAHAM AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-3840
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Country | US
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Telephone | 715-836-8460
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Fax | 715-836-8467
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Authorized Official
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Title or Position | CEO
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Name | KENNETH VAN ES
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Credential |
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Telephone | 715-836-8460
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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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