Provider Demographics
NPI:1598207821
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF METROPOLITAN FORT WORTH
Entity Type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF METROPOLITAN FORT WORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:HELM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-566-1062
Mailing Address - Street 1:512 LAMAR ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-3754
Mailing Address - Country:US
Mailing Address - Phone:817-335-9622
Mailing Address - Fax:817-335-7043
Practice Address - Street 1:5315 BOAT CLUB RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135
Practice Address - Country:US
Practice Address - Phone:817-237-7237
Practice Address - Fax:817-237-9311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-17
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty