Provider Demographics
NPI:1770028169
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE FOOTHILLS
Entity type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE FOOTHILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:SHAYNE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-790-0123
Mailing Address - Street 1:1930 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:LA CANADA FLINTRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91011-1933
Mailing Address - Country:US
Mailing Address - Phone:818-790-0123
Mailing Address - Fax:818-790-3774
Practice Address - Street 1:1930 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:LA CANADA FLINTRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91011-1933
Practice Address - Country:US
Practice Address - Phone:818-790-0123
Practice Address - Fax:818-790-3774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty