Provider Demographics
NPI:1508313529
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF SOUTH HAMPTON ROADS
Entity Type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF SOUTH HAMPTON ROADS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HERBERT
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-624-9622
Mailing Address - Street 1:920 CORPORATE LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3406
Mailing Address - Country:US
Mailing Address - Phone:757-624-9622
Mailing Address - Fax:757-627-4824
Practice Address - Street 1:920 CORPORATE LN
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3406
Practice Address - Country:US
Practice Address - Phone:757-624-9622
Practice Address - Fax:757-627-4824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty