Organization
OLD COLONY YMCA WELLNESS SERVICES, INC.
Active
Parent organization
OLD COLONY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
OLD COLONY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.
Authorized official
MR. CHARLES CLIFFORD (PRESIDENT & CEO)
(508) 897-1220
Entity
Organization
Contact information
Practice address
445 CENTRAL ST, STOUGHTON, MA 02072-1900
(781) 341-2016
Mailing address
320 MAIN ST, BROCKTON, MA 02301-5340
(508) 583-2155
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
—
—
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
Other
Enumeration date
10/08/2024
Last updated
10/25/2024
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