Stateline Family Young Men'S Christian Association, Inc

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

STATELINE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC

Practice address

1865 Riverside Dr
Beloit, WI 53511-3521

Phone

(608) 365-2261

Fax

(608) 365-7091

NPI assigned

Sep 27, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Doug Britt

Title

Ceo/Executive Director

Phone

(608) 365-2261

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474934400000",
    "number": "1578012936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 RIVERSIDE DR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113521",
            "telephone_number": "608-365-2261",
            "fax_number": "608-365-7091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 RIVERSIDE DR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113521",
            "telephone_number": "608-365-2261",
            "fax_number": "608-365-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATELINE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-27",
        "last_updated": "2016-09-27",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "CEO/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "608-365-2261",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Renee Stanis, BA, SAC-IT
• Betty Stanley, R.N.
• Shauna Stanton, LPN
• Leah Starnes
• Stateline Anesthesiologists SC
• Stateline Mental Health Services
• Robin Jo Staver, REG. NURSE
• Amanda J Stelzer, M.S., OTR/L
• Philip W Story, SW
• Randi K Stouffer, PHARMD

• Health Educator in Beloit, WI
• Providers in Beloit, WI by specialty
• Health Educator in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.