Provider Demographics
NPI:1396280319
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF GREATER SPARTANBURG
Entity type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF GREATER SPARTANBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLEBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-585-0306
Mailing Address - Street 1:151 RIBAULT ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-2630
Mailing Address - Country:US
Mailing Address - Phone:864-585-0306
Mailing Address - Fax:864-596-4135
Practice Address - Street 1:151 RIBAULT ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-2630
Practice Address - Country:US
Practice Address - Phone:864-585-0306
Practice Address - Fax:864-596-4135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty