Provider Demographics
NPI:1801344494
Name:CUMBERLAND CAPE ATLANTIC YOUNG MEN'S CHRISTIAN ASSOCIATION OF NJ
Entity type:Organization
Organization Name:CUMBERLAND CAPE ATLANTIC YOUNG MEN'S CHRISTIAN ASSOCIATION OF NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:STIENBRONN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-691-0030
Mailing Address - Street 1:1159 E LANDIS AVE
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-4220
Mailing Address - Country:US
Mailing Address - Phone:856-691-0030
Mailing Address - Fax:856-696-0121
Practice Address - Street 1:1159 E LANDIS AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-4220
Practice Address - Country:US
Practice Address - Phone:856-691-0030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty