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General NPI Number Information
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NPI Number | 1366953424
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Entity Type | Organization
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Legal Business Name | YOUNG MEN'S CHRISTIAN ASSOCIATION OF SOUTHERN MAINE
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Dates
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Enumeration Date | 10/17/2017
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Last Update Date | 10/17/2017
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Provider Practice Location Address
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Address Line | 70 FOREST AVE
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City | PORTLAND
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State | ME
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Zip | 04101-2813
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Country | US
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Telephone | 207-874-1111
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Fax | 207-842-2966
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Provider Business Mailing Address
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Address Line | 70 FOREST AVE
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City | PORTLAND
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State | ME
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Zip | 04101-2813
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Country | US
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Telephone | 207-874-1111
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Fax | 207-842-2966
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Authorized Official
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Title or Position | CEO
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Name | HELEN BRENA
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Credential |
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Telephone | 207-874-1111
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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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