Healthcare Provider Details

I. General information

NPI: 1639556004
Provider Name (Legal Business Name): TERRIE HESS CHILD ADVOCACY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 09/12/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 WOODSON STREET
SALISBURY NC
28144
US

IV. Provider business mailing address

130 WOODSON STREET
SALISBURY NC
28144
US

V. Phone/Fax

Practice location:
  • Phone: 704-639-1700
  • Fax: 704-642-1755
Mailing address:
  • Phone: 704-639-1700
  • Fax: 704-642-1755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080C0008X
TaxonomyChild Abuse Pediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. SHAWN EDMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 704-639-1700