Provider Demographics
NPI:1497290654
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF MONROE COUNTY, INC.
Entity Type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF MONROE COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:M
Authorized Official - Last Name:WINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:812-961-2371
Mailing Address - Street 1:2125 S HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-6773
Mailing Address - Country:US
Mailing Address - Phone:812-961-2175
Mailing Address - Fax:888-829-1237
Practice Address - Street 1:2125 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-6773
Practice Address - Country:US
Practice Address - Phone:812-961-2175
Practice Address - Fax:888-829-1237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty