Provider Demographics
NPI:1457892283
Name:EVANGELICAL ALUMNI INC.
Entity Type:Organization
Organization Name:EVANGELICAL ALUMNI INC.
Other - Org Name:E.A COLLEGE OF HEALTHCARE EXECUTIVES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BIOETHIC HEALTHCARE ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:215-914-5528
Mailing Address - Street 1:3232 N 33RD ST
Mailing Address - Street 2:3232 N 33RD ST
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1202
Mailing Address - Country:US
Mailing Address - Phone:215-914-5528
Mailing Address - Fax:215-702-2800
Practice Address - Street 1:3232 N 33RD ST
Practice Address - Street 2:3232 N 33RD ST
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19129-1202
Practice Address - Country:US
Practice Address - Phone:215-914-5528
Practice Address - Fax:215-702-2800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1288472320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness