Provider Demographics
NPI:1750880159
Name:THE FAMILY Y, YOUNG MEN'S CHRISTIAN ASSOCIATION/YWCO OF THE CSRA, INC.
Entity type:Organization
Organization Name:THE FAMILY Y, YOUNG MEN'S CHRISTIAN ASSOCIATION/YWCO OF THE CSRA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-922-9601
Mailing Address - Street 1:1058 CLAUSSEN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907
Mailing Address - Country:US
Mailing Address - Phone:706-922-9622
Mailing Address - Fax:706-723-1773
Practice Address - Street 1:1058 CLAUSSEN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907
Practice Address - Country:US
Practice Address - Phone:706-922-9622
Practice Address - Fax:706-723-1773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty