Provider Demographics
NPI:1669917860
Name:A YOUNG MEN'S CHRISTIAN ASSOCIATION OF ANCHORAGE, ALASKA
Entity type:Organization
Organization Name:A YOUNG MEN'S CHRISTIAN ASSOCIATION OF ANCHORAGE, ALASKA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:LEROY
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-563-3211
Mailing Address - Street 1:5353 LAKE OTIS PKWY
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1709
Mailing Address - Country:US
Mailing Address - Phone:907-563-3211
Mailing Address - Fax:907-563-5739
Practice Address - Street 1:5353 LAKE OTIS PKWY
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1709
Practice Address - Country:US
Practice Address - Phone:907-563-3211
Practice Address - Fax:907-563-5739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-23
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty