Provider Demographics
NPI:1578816153
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF MARQUETTE COUNTY
Entity Type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF MARQUETTE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZDUNEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-227-9622
Mailing Address - Street 1:1420 PINE ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-2962
Mailing Address - Country:US
Mailing Address - Phone:906-227-9622
Mailing Address - Fax:906-227-9248
Practice Address - Street 1:1420 PINE ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-2962
Practice Address - Country:US
Practice Address - Phone:906-227-9622
Practice Address - Fax:906-227-9248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-20
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or Welfare
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty