Provider Demographics
NPI:1205345014
Name:THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF CARBONDALE
Entity type:Organization
Organization Name:THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF CARBONDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:DURKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-282-2210
Mailing Address - Street 1:82 N MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18407
Mailing Address - Country:US
Mailing Address - Phone:570-282-2210
Mailing Address - Fax:570-282-3579
Practice Address - Street 1:82 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407
Practice Address - Country:US
Practice Address - Phone:570-282-2210
Practice Address - Fax:570-282-3579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty