Provider Demographics
NPI:1285002964
Name:FRIENDS OF CANAAN INCORPORATED
Entity Type:Organization
Organization Name:FRIENDS OF CANAAN INCORPORATED
Other - Org Name:CANAAN COMMUNITY ACADEMY
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-839-0003
Mailing Address - Street 1:8775 N CANAAN MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-8489
Mailing Address - Country:US
Mailing Address - Phone:812-839-0003
Mailing Address - Fax:
Practice Address - Street 1:8775 N CANAAN MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-8489
Practice Address - Country:US
Practice Address - Phone:812-839-0003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)