Provider Demographics
NPI:1376600221
Name:THE COMMUNITY YMCA FAMILY SERVICES
Entity Type:Organization
Organization Name:THE COMMUNITY YMCA FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FAMILY AND HUMAN SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-774-1558
Mailing Address - Street 1:166 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3104
Mailing Address - Country:US
Mailing Address - Phone:732-774-1558
Mailing Address - Fax:732-774-9465
Practice Address - Street 1:166 MAIN ST
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3104
Practice Address - Country:US
Practice Address - Phone:732-774-1558
Practice Address - Fax:732-774-9465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8842434Medicaid