Provider Demographics
NPI:1427228709
Name:CENTER FOR CHILD ABUSE PREVENTION AND TREATMENT
Entity Type:Organization
Organization Name:CENTER FOR CHILD ABUSE PREVENTION AND TREATMENT
Other - Org Name:FAMILY ENHANCEMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:BERGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:612-827-3028
Mailing Address - Street 1:4826 CHICAGO AVE. SOUTH
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417
Mailing Address - Country:US
Mailing Address - Phone:612-827-3028
Mailing Address - Fax:612-823-4993
Practice Address - Street 1:4826 CHICAGO AVE. SOUTH
Practice Address - Street 2:SUITE 105
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417
Practice Address - Country:US
Practice Address - Phone:612-827-3028
Practice Address - Fax:612-823-4993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health