Provider Demographics
NPI:1114477981
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE CHESAPEAKE, INC.
Entity Type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE CHESAPEAKE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LONDON
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-770-3890
Mailing Address - Street 1:111 E DOVER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3057
Mailing Address - Country:US
Mailing Address - Phone:410-770-3890
Mailing Address - Fax:410-770-3893
Practice Address - Street 1:111 E DOVER ST STE 1
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3057
Practice Address - Country:US
Practice Address - Phone:410-770-3890
Practice Address - Fax:410-770-3893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty