Provider Demographics
NPI:1245582170
Name:CHILDSAFE CENTER - CAC
Entity Type:Organization
Organization Name:CHILDSAFE CENTER - CAC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBER
Authorized Official - Suffix:
Authorized Official - Credentials:DCFI
Authorized Official - Phone:540-665-4426
Mailing Address - Street 1:411 N CAMERON ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4807
Mailing Address - Country:US
Mailing Address - Phone:540-665-4426
Mailing Address - Fax:540-665-4439
Practice Address - Street 1:411 N CAMERON ST
Practice Address - Street 2:SUITE 301
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4807
Practice Address - Country:US
Practice Address - Phone:540-665-4426
Practice Address - Fax:540-665-4439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health