Provider Demographics
NPI:1245787423
Name:THE GREATER SUSQUEHANNA VALLEY YOUNG MEN'S CHRISTIAN ASSOCIATION
Entity Type:Organization
Organization Name:THE GREATER SUSQUEHANNA VALLEY YOUNG MEN'S CHRISTIAN ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-286-5636
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17801-0390
Mailing Address - Country:US
Mailing Address - Phone:570-286-5636
Mailing Address - Fax:570-286-5961
Practice Address - Street 1:1150 N 4TH ST
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:PA
Practice Address - Zip Code:17801-1222
Practice Address - Country:US
Practice Address - Phone:570-286-5636
Practice Address - Fax:570-286-5961
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