Provider Demographics
NPI:1104373331
Name:THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF MARION COUNTY, OHIO
Entity Type:Organization
Organization Name:THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF MARION COUNTY, OHIO
Other - Org Name:MARION FAMILY YMCA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUBKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-725-9622
Mailing Address - Street 1:645 BARKS RD E
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6517
Mailing Address - Country:US
Mailing Address - Phone:740-725-9622
Mailing Address - Fax:740-389-1287
Practice Address - Street 1:645 BARKS RD E
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6517
Practice Address - Country:US
Practice Address - Phone:740-725-9622
Practice Address - Fax:740-389-1287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty