Provider Demographics
NPI:1376185785
Name:MOUNT DESERT ISLAND YMCA
Entity Type:Organization
Organization Name:MOUNT DESERT ISLAND YMCA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEN DIR HEALTHY LIVING AND AQUATICS
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-288-3511
Mailing Address - Street 1:21 PARK STREET
Mailing Address - Street 2:
Mailing Address - City:BAR HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04609
Mailing Address - Country:US
Mailing Address - Phone:207-288-3511
Mailing Address - Fax:
Practice Address - Street 1:21 PARK STREET
Practice Address - Street 2:
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04609
Practice Address - Country:US
Practice Address - Phone:207-288-3511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty