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General NPI Number Information
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NPI Number | 1467620518
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Entity Type | Organization
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Legal Business Name | I CAN & ASSOCIATES, INC
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 02/12/2008
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Provider Practice Location Address
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Address Line | 421 SPARROW DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-8232
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Country | US
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Telephone | 910-860-9787
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 25433
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-5007
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Country | US
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Telephone | 910-860-9787
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, OWNER
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Name | MRS. SHANNON BATTLE
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Credential | M.A
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Telephone | 910-860-9787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | MHL-047-055
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License Number State | NC
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