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General NPI Number Information
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NPI Number | 1225587785
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Entity Type | Organization
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Legal Business Name | NORM WAITT SR. YOUNG MEN'S CHRISTIAN ASSOCIATION
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Dates
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Enumeration Date | 09/26/2016
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Last Update Date | 09/26/2016
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Provider Practice Location Address
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Address Line | 601 RIVERVIEW DR
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City | SOUTH SIOUX CITY
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State | NE
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Zip | 68776-3581
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Country | US
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Telephone | 402-404-8439
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Fax | 402-404-8444
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Provider Business Mailing Address
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Address Line | 601 RIVERVIEW DR
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City | SOUTH SIOUX CITY
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State | NE
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Zip | 68776-3581
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Country | US
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Telephone | 402-404-8439
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Fax | 402-404-8444
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Authorized Official
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Title or Position | CEO
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Name | KEVIN ENGEL-CARTIE
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Credential |
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Telephone | 402-404-8439
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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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