Organization
ICAN & ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON M BATTLE M.A. (DIRECTOR)
(910) 860-9787
Entity
Organization
Contact information
Practice address
6112 LOUISE ST, FAYETTEVILLE, NC 28314-2719
(910) 860-9787
(910) 860-3903
Mailing address
PO BOX 25433, FAYETTEVILLE, NC 28314-5007
(910) 860-9787
(910) 860-3903
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
10312009
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
026597
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
047055
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL047055
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
261QM0801X
LME
NC
Enumeration date
02/22/2007
Last updated
12/15/2009
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