Provider Demographics
NPI:1851904502
Name:SHENANGO VALLEY YMCA
Entity Type:Organization
Organization Name:SHENANGO VALLEY YMCA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:STATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-981-6950
Mailing Address - Street 1:925 N HERMITAGE RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3219
Mailing Address - Country:US
Mailing Address - Phone:724-981-6950
Mailing Address - Fax:724-981-6951
Practice Address - Street 1:925 N HERMITAGE RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3219
Practice Address - Country:US
Practice Address - Phone:724-981-6950
Practice Address - Fax:724-981-6951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty