Provider Demographics
NPI:1932655800
Name:YOUNG MENS CHRISTIAN ASSOCIATION OF THE CEDAR RAPIDS METROPOLITAN AREA
Entity Type:Organization
Organization Name:YOUNG MENS CHRISTIAN ASSOCIATION OF THE CEDAR RAPIDS METROPOLITAN AREA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-366-6421
Mailing Address - Street 1:207 7TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401-2001
Mailing Address - Country:US
Mailing Address - Phone:319-366-6421
Mailing Address - Fax:866-363-3681
Practice Address - Street 1:5264 COUNCIL ST NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-2471
Practice Address - Country:US
Practice Address - Phone:319-378-5955
Practice Address - Fax:866-363-3681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty