Provider Demographics
NPI:1053646422
Name:CHILD ABUSE COUNCIL
Entity Type:Organization
Organization Name:CHILD ABUSE COUNCIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:D'AGOSTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-673-4646
Mailing Address - Street 1:3108 W AZEELE ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3059
Mailing Address - Country:US
Mailing Address - Phone:813-673-4646
Mailing Address - Fax:813-673-4644
Practice Address - Street 1:3108 W AZEELE ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3059
Practice Address - Country:US
Practice Address - Phone:813-673-4646
Practice Address - Fax:813-673-4644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management