Healthcare Provider Details

I. General information

NPI: 1952421307
Provider Name (Legal Business Name): CHILDREN'S ADVOCACY NETWORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3302 S NEW HOPE RD SUITE 200-B
GASTONIA NC
28056-8317
US

IV. Provider business mailing address

3302 S NEW HOPE RD SUITE 200-B
GASTONIA NC
28056-8317
US

V. Phone/Fax

Practice location:
  • Phone: 704-824-3400
  • Fax: 704-824-3453
Mailing address:
  • Phone: 704-824-3400
  • Fax: 704-824-3453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. VICKIE K MCDUFFIE
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 704-824-3400