Provider Demographics
NPI:1508311580
Name:YOUNG MEN CHRISTIAN ASSOCIATION OF WESTERN NORTH CAROLINA
Entity Type:Organization
Organization Name:YOUNG MEN CHRISTIAN ASSOCIATION OF WESTERN NORTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BLENCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-559-2405
Mailing Address - Street 1:40 N MERRIMON AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-1368
Mailing Address - Country:US
Mailing Address - Phone:828-251-5909
Mailing Address - Fax:828-251-2437
Practice Address - Street 1:348 GRACE CORPENING DRIVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752
Practice Address - Country:US
Practice Address - Phone:828-210-5040
Practice Address - Fax:828-559-2151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-19
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty