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General NPI Number Information
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NPI Number | 1801346846
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Entity Type | Organization
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Legal Business Name | YOUNG MEN'S CHRISTIAN ASSOCIATION OF NORTHEAST LOUISIANA
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Dates
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Enumeration Date | 10/13/2016
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 1505 STUBBS AVE
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City | MONROE
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State | LA
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Zip | 71201-5627
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Country | US
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Telephone | 318-387-9622
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Fax | 318-703-3626
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Provider Business Mailing Address
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Address Line | 1505 STUBBS AVE
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City | MONROE
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State | LA
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Zip | 71201-5627
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Country | US
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Telephone | 318-387-9622
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Fax | 318-703-3626
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Authorized Official
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Title or Position | PRESIDENT-CEO
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Name | MR. ELLIS M LEWIS
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Credential |
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Telephone | 318-331-1681
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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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