The Benton Harbor-St. Joseph Young Men'S Christian Association

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

THE BENTON HARBOR-ST. JOSEPH YOUNG MEN'S CHRISTIAN ASSOCIATION

Practice address

3665 Hollywood Rd
Saint Joseph, MI 49085-9581

Phone

(269) 428-9622

Fax

(269) 429-5482

NPI assigned

Sep 8, 2016

Organization subpart

No

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

Authorized official

Name

Mark Weber

Title

Chief Executive Officer

Phone

(269) 428-9622

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1609323559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3665 HOLLYWOOD RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859581",
            "telephone_number": "269-428-9622",
            "fax_number": "269-429-5482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3665 HOLLYWOOD RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859581",
            "telephone_number": "269-428-9622",
            "fax_number": "269-429-5482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BENTON HARBOR-ST. JOSEPH YOUNG MEN'S CHRISTIAN ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "269-428-9622"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Educator in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Health Educator in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.