Provider Demographics
NPI:1225178460
Name:NOTHWEST ALABAMA CHILDRENS ADVOCACY CENTER, INC
Entity Type:Organization
Organization Name:NOTHWEST ALABAMA CHILDRENS ADVOCACY CENTER, INC
Other - Org Name:CRAMER CHILDRENS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FORENSICS
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HADDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-760-1140
Mailing Address - Street 1:404 W TENNESSEE ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5525
Mailing Address - Country:US
Mailing Address - Phone:256-760-1140
Mailing Address - Fax:256-764-3164
Practice Address - Street 1:404 W TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5525
Practice Address - Country:US
Practice Address - Phone:256-760-1140
Practice Address - Fax:256-764-3164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1048599363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty