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General NPI Number Information
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NPI Number | 1588115208
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Entity Type | Organization
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Legal Business Name | THE COMMUNITY YOUNG MEN'S CHRISTIAN ASSOCIATION OF GREENFIELD, MASS
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Dates
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Enumeration Date | 10/18/2016
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Last Update Date | 10/18/2016
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Provider Practice Location Address
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Address Line | 451 MAIN ST
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City | GREENFIELD
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State | MA
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Zip | 01301-3304
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Country | US
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Telephone | 413-773-3646
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Fax | 413-774-4312
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Provider Business Mailing Address
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Address Line | 451 MAIN ST
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City | GREENFIELD
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State | MA
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Zip | 01301-3304
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Country | US
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Telephone | 413-773-3646
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Fax | 413-774-4312
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROBERT SUNDERLAND
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Credential |
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Telephone | 413-773-3646
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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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