Provider Demographics
NPI:1780131508
Name:CLEVELAND COUNTY FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.
Entity type:Organization
Organization Name:CLEVELAND COUNTY FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-669-3622
Mailing Address - Street 1:PO BOX 2272
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28151-2272
Mailing Address - Country:US
Mailing Address - Phone:704-484-9622
Mailing Address - Fax:704-669-3673
Practice Address - Street 1:411 CHERRYVILLE RD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3651
Practice Address - Country:US
Practice Address - Phone:704-484-9622
Practice Address - Fax:704-669-3673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-09
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty