Provider Demographics
NPI:1710522073
Name:YOUNG MEN'S AND WOMEN'S CHRISTIAN ASSOCIATION OF THE GREATER TR-VALLEY
Entity Type:Organization
Organization Name:YOUNG MEN'S AND WOMEN'S CHRISTIAN ASSOCIATION OF THE GREATER TR-VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTHY LIVING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEIGHNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-336-3500
Mailing Address - Street 1:301 W BLOOMFIELD ST
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-4198
Mailing Address - Country:US
Mailing Address - Phone:315-336-3500
Mailing Address - Fax:
Practice Address - Street 1:301 W BLOOMFIELD ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-4198
Practice Address - Country:US
Practice Address - Phone:315-336-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty