Provider Demographics
NPI:1194272518
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE SUNCOAST, INC.
Entity type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE SUNCOAST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:G.
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:GOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-467-9622
Mailing Address - Street 1:2469 ENTERPRISE RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-1702
Mailing Address - Country:US
Mailing Address - Phone:727-467-9622
Mailing Address - Fax:
Practice Address - Street 1:4550 VILLAGE CENTER DR
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-1224
Practice Address - Country:US
Practice Address - Phone:727-772-9622
Practice Address - Fax:727-785-1806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty