# JOHNNY CARES INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JOHNNY CARES INC
- **Other names:** Waverly Health & Fitness Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962899955
- **Legal business name:** JOHNNY CARES INC
- **Authorized official:** MR. WILLIAM GREEN (MANAGING AGENT)
- **Authorized official phone:** (410) 467-6040

## Contact information

- **Practice address:** 3028 GREENMOUNT AVE, BALTIMORE, MD 21218-3938
- **Practice address phone:** (410) 467-6040
- **Practice address fax:** (410) 467-5944
- **Mailing address:** 1734 MARYLAND AVE, BALTIMORE, MD 21201-5804
- **Mailing address phone:** (410) 467-6040
- **Mailing address fax:** (410) 467-5944

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/17/2015
- **Last updated:** 04/17/2015