Provider Demographics
NPI:1790234821
Name:THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF GREATER TULSA
Entity Type:Organization
Organization Name:THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF GREATER TULSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PLANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-728-3911
Mailing Address - Street 1:420 S MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74103-3900
Mailing Address - Country:US
Mailing Address - Phone:918-728-3914
Mailing Address - Fax:918-712-4272
Practice Address - Street 1:420 S MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-3900
Practice Address - Country:US
Practice Address - Phone:918-728-3914
Practice Address - Fax:918-712-4272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty