Provider Demographics
NPI:1336696533
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF MADISON, N.J.
Entity Type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF MADISON, N.J.
Other - Org Name:MADISON AREA YMCA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-822-9622
Mailing Address - Street 1:111 KINGS RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-2122
Mailing Address - Country:US
Mailing Address - Phone:973-822-9622
Mailing Address - Fax:973-377-1064
Practice Address - Street 1:111 KINGS RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2122
Practice Address - Country:US
Practice Address - Phone:973-822-9622
Practice Address - Fax:973-377-1064
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