Provider Demographics
NPI:1487180493
Name:YMCA CAMP MANITOU-LIN
Entity Type:Organization
Organization Name:YMCA CAMP MANITOU-LIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DENMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-795-9163
Mailing Address - Street 1:1095 N BRIGGS RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49333-9700
Mailing Address - Country:US
Mailing Address - Phone:269-795-9163
Mailing Address - Fax:269-795-1629
Practice Address - Street 1:1095 N BRIGGS RD
Practice Address - Street 2:
Practice Address - City:MIDDLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:49333-9700
Practice Address - Country:US
Practice Address - Phone:269-795-9163
Practice Address - Fax:269-795-1629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISR080200024385HR2050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp