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General NPI Number Information
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NPI Number | 1932644119
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Entity Type | Organization
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Legal Business Name | YOUNG MEN'S CHRISTIAN ASSOCIATION OF SOUTHEASTERN NORTH CAROLINA, INC.
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Dates
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Enumeration Date | 12/27/2016
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Last Update Date | 12/27/2016
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Provider Practice Location Address
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Address Line | 11 S KERR AVE
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City | WILMINGTON
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State | NC
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Zip | 28403-1416
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Country | US
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Telephone | 910-251-9622
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Fax | 910-251-2509
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Provider Business Mailing Address
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Address Line | 3825 MARKET ST
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City | WILMINGTON
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State | NC
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Zip | 28403-1453
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Country | US
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Telephone | 910-251-9622
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Fax | 910-251-2509
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | DICK JONES
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Credential |
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Telephone | 910-251-9622
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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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