Provider Demographics
NPI:1427504398
Name:THE YOUNG MENS CHRISTIAN ASSOCIATION OF BOISE CITY IDAHO
Entity type:Organization
Organization Name:THE YOUNG MENS CHRISTIAN ASSOCIATION OF BOISE CITY IDAHO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:O'NEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-344-5502
Mailing Address - Street 1:1177 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-5346
Mailing Address - Country:US
Mailing Address - Phone:208-344-5501
Mailing Address - Fax:866-261-4820
Practice Address - Street 1:419 N 11TH ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702
Practice Address - Country:US
Practice Address - Phone:208-344-5502
Practice Address - Fax:866-259-6758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty