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General NPI Number Information
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NPI Number | 1619428257
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Entity Type | Organization
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Legal Business Name | YOUNG MEN'S CHRISTIAN ASSOCIATION OF NORTHWEST FLORIDA, INC.
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Dates
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Enumeration Date | 10/19/2016
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Last Update Date | 10/19/2016
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Provider Practice Location Address
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Address Line | 165 E.INTENDENCIA STREET
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City | PENSACOLA
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State | FL
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Zip | 32502
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Country | US
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Telephone | 850-438-4406
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Fax | 850-465-0596
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Provider Business Mailing Address
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Address Line | 415 N TARRAGONA ST STE B
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City | PENSACOLA
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State | FL
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Zip | 32501-3969
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Country | US
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Telephone | 850-432-8327
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Fax | 850-465-9924
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BILL SEEDES
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Credential |
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Telephone | 850-438-4406
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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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