Provider Demographics
NPI:1164970745
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF METROPOLITAN DALLAS
Entity Type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF METROPOLITAN DALLAS
Other - Org Name:YMCA OF METROPOLITAN DALLAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:CURT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAZELBAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-269-9622
Mailing Address - Street 1:601 N AKARD ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-3303
Mailing Address - Country:US
Mailing Address - Phone:214-880-9622
Mailing Address - Fax:972-560-3832
Practice Address - Street 1:1621 W WALNUT HILL LN
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038
Practice Address - Country:US
Practice Address - Phone:214-880-9622
Practice Address - Fax:214-871-3014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-13
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty