Provider Demographics
NPI:1285181230
Name:THE CHEYENNE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION
Entity Type:Organization
Organization Name:THE CHEYENNE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-634-9622
Mailing Address - Street 1:1426 E LINCOLNWAY
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4800
Mailing Address - Country:US
Mailing Address - Phone:307-634-9622
Mailing Address - Fax:307-635-5063
Practice Address - Street 1:1426 E LINCOLNWAY
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4800
Practice Address - Country:US
Practice Address - Phone:307-634-9622
Practice Address - Fax:307-635-5063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty