Provider Demographics
NPI:1427590413
Name:GOLDSBORO FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION
Entity Type:Organization
Organization Name:GOLDSBORO FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-778-8557
Mailing Address - Street 1:PO BOX 10355
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27532-0355
Mailing Address - Country:US
Mailing Address - Phone:919-778-8557
Mailing Address - Fax:919-778-8645
Practice Address - Street 1:1105 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-3447
Practice Address - Country:US
Practice Address - Phone:919-778-8557
Practice Address - Fax:919-778-8645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty