Provider Demographics
NPI:1427507540
Name:MARSHALL AREA YOUNG MEN'S CHRISTIAN ASSOCIATION
Entity type:Organization
Organization Name:MARSHALL AREA YOUNG MEN'S CHRISTIAN ASSOCIATION
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:BOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-532-9622
Mailing Address - Street 1:200 S A ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-1700
Mailing Address - Country:US
Mailing Address - Phone:507-532-9622
Mailing Address - Fax:507-537-3589
Practice Address - Street 1:200 S A ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-1700
Practice Address - Country:US
Practice Address - Phone:507-532-9622
Practice Address - Fax:507-537-3589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty