Organization
JOHNNYCARES, INC.
Active
Parent organization
JOHNNYCARES, INC.
Other names
MedHealth@Waverly
Organization subpart
Yes
Provider details
NPI number
Legal business name
JOHNNYCARES, INC.
Authorized official
MR. WILLIAM GREEN (MANAGING AGENT)
(410) 467-6040
Entity
Organization
Contact information
Practice address
3028 GREENMOUNT AVE, BALTIMORE, MD 21218-3938
(410) 467-6040
Mailing address
1734 MARYLAND AVE, BALTIMORE, MD 21201-5804
(410) 467-6040
(410) 467-5944
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/25/2015
Last updated
08/12/2015
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