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General NPI Number Information
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NPI Number | 1497920367
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Entity Type | Organization
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Legal Business Name | THE CHILDREN'S ADVOCACY CENTER
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 1011 W INTERNATIONAL SPEEDWAY BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-3421
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Country | US
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Telephone | 386-238-3830
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Fax | 386-238-2018
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Provider Business Mailing Address
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Address Line | 1011 W INTERNATIONAL SPEEDWAY BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-3421
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Country | US
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Telephone | 386-238-3830
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Fax | 386-238-2018
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. DARLENE LEE STEWART
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Credential | LMHC
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Telephone | 386-238-3830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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