Provider Demographics
NPI:1043729841
Name:CHRISTIAN COUNTY YOUNG MEN'S CHRISTIAN ASSOCIATION INC
Entity Type:Organization
Organization Name:CHRISTIAN COUNTY YOUNG MEN'S CHRISTIAN ASSOCIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WEITTENHILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-287-7271
Mailing Address - Street 1:900 MCADAM DR
Mailing Address - Street 2:
Mailing Address - City:TAYLORVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62568
Mailing Address - Country:US
Mailing Address - Phone:217-287-7271
Mailing Address - Fax:217-824-2348
Practice Address - Street 1:900 MCADAM DR
Practice Address - Street 2:
Practice Address - City:TAYLORVILLE
Practice Address - State:IL
Practice Address - Zip Code:62568
Practice Address - Country:US
Practice Address - Phone:217-287-7271
Practice Address - Fax:217-824-2348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty