MEDICARE: YES WE CAN TOO LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1710123807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YES WE CAN TOO LLC.

Provider Business Mailing Address
First Line	:	1914 J N PEASE PL
Second Line	:	#110
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4504
Country	:	US
Telephone Number	:	704-919-3538
Fax Number	:	704-919-3539

Provider Business Practice Location Address
First Line	:	1914 J N PEASE PL
Second Line	:	#110
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4504
Country	:	US
Telephone Number	:	704-919-3538
Fax Number	:	704-919-3539

Authorized Official
Title or Position	:	OWNER
Name	:	MS. DIANE MOSLEY
Credential	:
Telephone Number	:	919-638-0574

Provider Enumeration Date	:	12/19/2008
Last Update Date	:	12/19/2008

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