Healthcare Provider Details

I. General information

NPI: 1912198912
Provider Name (Legal Business Name): CHILDREN'S ADVOCACY CENTER OF SPARTANBURG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 08/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WASHINGTON PL
SPARTANBURG SC
29302-1295
US

IV. Provider business mailing address

PO BOX 6007
SPARTANBURG SC
29304-6007
US

V. Phone/Fax

Practice location:
  • Phone: 864-515-9922
  • Fax: 864-515-9919
Mailing address:
  • Phone: 864-515-9922
  • Fax: 864-515-9919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. BILL HERRICK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 864-515-9922