Provider Demographics
NPI:1023265576
Name:THE CHILDREN'S ADVOCACY CENTER
Entity type:Organization
Organization Name:THE CHILDREN'S ADVOCACY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:602-369-8845
Mailing Address - Street 1:1855 E NORTHERN AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-3963
Mailing Address - Country:US
Mailing Address - Phone:602-861-6735
Mailing Address - Fax:602-997-1123
Practice Address - Street 1:1855 E NORTHERN AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-3963
Practice Address - Country:US
Practice Address - Phone:602-861-6735
Practice Address - Fax:602-997-1123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2542251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health