Provider Demographics
NPI:1255887188
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF MICHIANA INC.
Entity type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF MICHIANA INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ASLESON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-287-9622
Mailing Address - Street 1:1201 NORTHSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46615-3921
Mailing Address - Country:US
Mailing Address - Phone:574-287-6922
Mailing Address - Fax:574-282-3752
Practice Address - Street 1:1201 NORTHSIDE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46615-3921
Practice Address - Country:US
Practice Address - Phone:574-287-6922
Practice Address - Fax:574-282-3752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty