Provider Demographics
NPI:1992171896
Name:YOUNG WOMEN'S CHRISTIAN ASSOCIATION OF DAYTON OHIO
Entity type:Organization
Organization Name:YOUNG WOMEN'S CHRISTIAN ASSOCIATION OF DAYTON OHIO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:TL
Authorized Official - Last Name:ISOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-461-5550
Mailing Address - Street 1:141 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-1814
Mailing Address - Country:US
Mailing Address - Phone:937-461-5550
Mailing Address - Fax:937-222-0610
Practice Address - Street 1:141 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1814
Practice Address - Country:US
Practice Address - Phone:937-461-5550
Practice Address - Fax:937-222-0610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health