Provider Demographics
NPI:1063969079
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF CENTRAL TEXAS
Entity type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF CENTRAL TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-776-6612
Mailing Address - Street 1:6800 HARVEY DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7808
Mailing Address - Country:US
Mailing Address - Phone:254-776-6612
Mailing Address - Fax:254-751-0974
Practice Address - Street 1:6800 HARVEY DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7808
Practice Address - Country:US
Practice Address - Phone:254-776-6612
Practice Address - Fax:254-751-0974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty