NPIMap

Organization Active NPI

Young Mens Christian Association

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Racine, WI
National Provider Identifier
1962166744
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
YOUNG MENS CHRISTIAN ASSOCIATION
Practice address
420 7TH Street
Racine, WI 53403-1222
Phone
(262) 634-2391
Fax
(262) 634-5342
NPI assigned
Oct 27, 2021
Last updated
Oct 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Authorized official

Name
Mr. Ahmed Qawi
Title
Ceo/President
Phone
(262) 634-1994

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

420 7TH Street
Racine, WI 53403-1222

Mailing address

420 7TH Street
Racine, WI 53403-1222
Phone (262) 634-2391

Other identifiers 1

IdentifierTypeStateIssuer
42128100MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
The Young Men's Christian Association of Racine Wisconsin3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1962166744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 7TH STREET",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031222",
            "telephone_number": "262-634-2391",
            "fax_number": "262-634-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 7TH STREET",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031222",
            "telephone_number": "262-634-2391",
            "fax_number": "262-634-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG MENS CHRISTIAN ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "QAWI",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "262-634-1994",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42128100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.