Provider Demographics
NPI:1033665971
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF SOUTHWESTERN INDIANA, INC.
Entity Type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF SOUTHWESTERN INDIANA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-423-9622
Mailing Address - Street 1:222 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47708-1308
Mailing Address - Country:US
Mailing Address - Phone:812-423-9622
Mailing Address - Fax:812-426-6211
Practice Address - Street 1:222 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47708-1308
Practice Address - Country:US
Practice Address - Phone:812-423-9622
Practice Address - Fax:812-426-6211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty