Provider Demographics
NPI:1336695287
Name:THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF WICHITA, KANSAS
Entity Type:Organization
Organization Name:THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF WICHITA, KANSAS
Other - Org Name:GREATER WICHITA YMCA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMAHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-776-8801
Mailing Address - Street 1:402 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-2012
Mailing Address - Country:US
Mailing Address - Phone:316-219-9622
Mailing Address - Fax:316-264-0757
Practice Address - Street 1:402 N MARKET ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202
Practice Address - Country:US
Practice Address - Phone:316-219-9622
Practice Address - Fax:316-264-0757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty