Provider Demographics
NPI:1932659703
Name:YOUNG MENS CHRISTIAN ASSOCIATION OF CENTRAL STARK COUNTY, INC.
Entity Type:Organization
Organization Name:YOUNG MENS CHRISTIAN ASSOCIATION OF CENTRAL STARK COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHETZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-491-9622
Mailing Address - Street 1:1201 30TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-2959
Mailing Address - Country:US
Mailing Address - Phone:330-491-9622
Mailing Address - Fax:330-491-8157
Practice Address - Street 1:7389 CARITAS CIR NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-9118
Practice Address - Country:US
Practice Address - Phone:330-830-6275
Practice Address - Fax:330-837-9587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty