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General NPI Number Information
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NPI Number | 1477002392
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI GULF COAST YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 10/04/2016
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Provider Practice Location Address
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Address Line | 1810 GOVERNMENT ST
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3931
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Country | US
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Telephone | 228-875-5050
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Fax | 228-872-4457
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Provider Business Mailing Address
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Address Line | 1810 GOVERNMENT ST
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3931
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Country | US
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Telephone | 228-875-5050
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Fax | 228-872-4457
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Authorized Official
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Title or Position | CFO
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Name | MACHELLE BROWN
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Credential |
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Telephone | 601-606-8427
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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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