Provider Demographics
NPI:1134634561
Name:EASTERN CAROLINA YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.
Entity type:Organization
Organization Name:EASTERN CAROLINA YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:W
Authorized Official - Last Name:SHUART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-638-8799
Mailing Address - Street 1:100 YMCA LANE
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560
Mailing Address - Country:US
Mailing Address - Phone:252-638-8799
Mailing Address - Fax:
Practice Address - Street 1:100 YMCA LANE
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560
Practice Address - Country:US
Practice Address - Phone:252-638-8799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty