Provider Demographics
NPI:1740739275
Name:OWEN COUNTY FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION
Entity type:Organization
Organization Name:OWEN COUNTY FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-828-9622
Mailing Address - Street 1:1111 W. STATE HWY 46
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IN
Mailing Address - Zip Code:47460
Mailing Address - Country:US
Mailing Address - Phone:812-828-9622
Mailing Address - Fax:812-828-9329
Practice Address - Street 1:1111 W. STATE HWY 46
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IN
Practice Address - Zip Code:47460
Practice Address - Country:US
Practice Address - Phone:812-828-9622
Practice Address - Fax:812-828-9329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty