Provider Demographics
NPI:1427521327
Name:THE ANDRE NORMAN ACADEMY (TANA)
Entity type:Organization
Organization Name:THE ANDRE NORMAN ACADEMY (TANA)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:215-715-9666
Mailing Address - Street 1:622 W CHEW AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-2211
Mailing Address - Country:US
Mailing Address - Phone:215-715-9666
Mailing Address - Fax:
Practice Address - Street 1:622 W CHEW AVE STE 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-2211
Practice Address - Country:US
Practice Address - Phone:215-715-9666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No385H00000XRespite Care FacilityRespite Care