Provider Demographics
NPI:1982240859
Name:EVANGELICAL ALUMNI FOUNDATION CORPORATION
Entity Type:Organization
Organization Name:EVANGELICAL ALUMNI FOUNDATION CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH ENGINEER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-485-2586
Mailing Address - Street 1:3242 W ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-1012
Mailing Address - Country:US
Mailing Address - Phone:215-485-2586
Mailing Address - Fax:
Practice Address - Street 1:1315 WALNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4719
Practice Address - Country:US
Practice Address - Phone:215-914-5528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness