Provider Demographics
NPI:1235548850
Name:CAC FOUNDATION, INC.
Entity Type:Organization
Organization Name:CAC FOUNDATION, INC.
Other - Org Name:OSWEGO COUNTY CHILD ADVOCACY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KARRIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:DAMM
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:315-592-4453
Mailing Address - Street 1:301 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-2409
Mailing Address - Country:US
Mailing Address - Phone:315-592-4453
Mailing Address - Fax:315-598-7158
Practice Address - Street 1:301 BEECH ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-2409
Practice Address - Country:US
Practice Address - Phone:315-592-4453
Practice Address - Fax:315-598-7158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCW-187-48251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health