Provider Demographics
NPI:1063864254
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF CUMBERLAND, MARYLAND, INCORPORATE
Entity Type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF CUMBERLAND, MARYLAND, INCORPORATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:ENTERLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-777-9622
Mailing Address - Street 1:601 KELLY ROAD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502
Mailing Address - Country:US
Mailing Address - Phone:301-777-9622
Mailing Address - Fax:301-777-3467
Practice Address - Street 1:601 KELLY ROAD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502
Practice Address - Country:US
Practice Address - Phone:301-777-9622
Practice Address - Fax:301-777-3467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty