Provider Demographics
NPI:1699377119
Name:THE GRANITE YMCA
Entity Type:Organization
Organization Name:THE GRANITE YMCA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATION DIRECTOR OF HEALTHY LIV
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-232-8650
Mailing Address - Street 1:117 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1933
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 MECHANIC ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1923
Practice Address - Country:US
Practice Address - Phone:603-623-3558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health