Provider Demographics
NPI:1699195289
Name:CHILD ADVOCACY CENTER OF AIKEN COUNTY
Entity Type:Organization
Organization Name:CHILD ADVOCACY CENTER OF AIKEN COUNTY
Other - Org Name:CAC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-644-5100
Mailing Address - Street 1:4231 TROLLEY LINE RD
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-2749
Mailing Address - Country:US
Mailing Address - Phone:803-644-5100
Mailing Address - Fax:803-644-7233
Practice Address - Street 1:4231 TROLLEY LINE RD
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-2749
Practice Address - Country:US
Practice Address - Phone:803-644-5100
Practice Address - Fax:804-644-7233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-22
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251V00000XAgenciesVoluntary or CharitableGroup - Single Specialty
No2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse PediatricsGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health