Provider Demographics
NPI:1821547951
Name:GREEN COUNTY FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION
Entity type:Organization
Organization Name:GREEN COUNTY FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:K
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-325-2003
Mailing Address - Street 1:1307 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-1169
Mailing Address - Country:US
Mailing Address - Phone:608-325-2003
Mailing Address - Fax:608-325-2058
Practice Address - Street 1:1307 2ND ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-1169
Practice Address - Country:US
Practice Address - Phone:608-325-2003
Practice Address - Fax:608-325-2058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty