Provider Demographics
NPI:1871040691
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF GREATER CHARLOTTE
Entity Type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF GREATER CHARLOTTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:TIBBITS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-716-6060
Mailing Address - Street 1:400 E MOREHEAD ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-2610
Mailing Address - Country:US
Mailing Address - Phone:704-716-6200
Mailing Address - Fax:
Practice Address - Street 1:400 E MOREHEAD ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2610
Practice Address - Country:US
Practice Address - Phone:704-716-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty