Provider Demographics
NPI:1194272955
Name:THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF LENAWEE COUNTY
Entity type:Organization
Organization Name:THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF LENAWEE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:MACNAUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-417-6102
Mailing Address - Street 1:638 W MAUMEE ST
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-2030
Mailing Address - Country:US
Mailing Address - Phone:517-263-2151
Mailing Address - Fax:517-263-2153
Practice Address - Street 1:638 W MAUMEE ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-2030
Practice Address - Country:US
Practice Address - Phone:517-263-2151
Practice Address - Fax:517-263-2153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty