Provider Demographics
NPI:1639626674
Name:OSHKOSH COMMUNITY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.
Entity type:Organization
Organization Name:OSHKOSH COMMUNITY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HIPPA COMPLIANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-230-8915
Mailing Address - Street 1:3303 W 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-9249
Mailing Address - Country:US
Mailing Address - Phone:920-230-8439
Mailing Address - Fax:920-230-8444
Practice Address - Street 1:3303 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-9249
Practice Address - Country:US
Practice Address - Phone:920-230-8439
Practice Address - Fax:920-230-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty