Whalio Doctors

NPI 1063547701

Ican & Associates, INC.

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Fayetteville, NC

Practice location

Address
6112 Louise St, Fayetteville, NC 28314-2719
Phone
(910) 860-9787
Fax
(910) 860-3903
Mailing address
PO Box 25433, Fayetteville, NC 28314-5007

Authorised official

Name
Shannon M Battle
Title
Director
Phone
(910) 860-9787

Registered specialties (4)

Emotionally Disturbed Childrens' Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 322D00000X Licence 047055 (NC)
Foster Care Agency
Agencies Taxonomy 253J00000X Licence 10312009 (NC)
Emotionally Disturbed Childrens' Residential Treatment Facility
Residential Treatment Facilities Taxonomy 322D00000X Licence 026597 (NC)
Emotionally Disturbed Childrens' Residential Treatment Facility
Residential Treatment Facilities Taxonomy 322D00000X Licence MHL047055 (NC)

Registry record

NPI
1063547701
Entity type
Organization
NPI issued
22 Feb 2007
Record last updated
15 Dec 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.