Provider Demographics
NPI:1215486790
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE FOX CITIES, INC.
Entity type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE FOX CITIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:BREIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-954-7601
Mailing Address - Street 1:218 E LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-5724
Mailing Address - Country:US
Mailing Address - Phone:920-739-6135
Mailing Address - Fax:920-734-2000
Practice Address - Street 1:W6931 SCHOOL RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:WI
Practice Address - Zip Code:54942-9639
Practice Address - Country:US
Practice Address - Phone:920-757-9820
Practice Address - Fax:920-757-9830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty