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General NPI Number Information
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NPI Number | 1801948070
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Entity Type | Organization
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Legal Business Name | I CAN'T - WE CAN, INC.
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 4432 PARK HEIGHTS AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-6324
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Country | US
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Telephone | 410-466-8833
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 67160
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City | BALTIMORE
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State | MD
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Zip | 21215-0042
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. ISRAEL CASON
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Credential | CAC-AD
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Telephone | 410-466-8833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 903036
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License Number State | MD
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