Provider Demographics
NPI:1700334539
Name:SANTA MONICA YOUNG MEN'S CHRISTIAN ASSOCIATION
Entity Type:Organization
Organization Name:SANTA MONICA YOUNG MEN'S CHRISTIAN ASSOCIATION
Other - Org Name:SANTA MONICA FAMILY YMCA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:K
Authorized Official - Last Name:POMPOSINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-393-2721
Mailing Address - Street 1:PO BOX 1160
Mailing Address - Street 2:1332 6TH STREET
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90406-1160
Mailing Address - Country:US
Mailing Address - Phone:310-393-2721
Mailing Address - Fax:310-451-9906
Practice Address - Street 1:1332 6TH ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1604
Practice Address - Country:US
Practice Address - Phone:310-393-2721
Practice Address - Fax:310-451-9906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty