Organization
I CANT-WE CAN COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA THOMAS (DIRECTOR)
(410) 824-8149
Entity
Organization
Contact information
Practice address
4432 PARK HEIGHTS AVE, BALTIMORE, MD 21215-6315
(410) 728-5174
(410) 728-5729
Mailing address
4432 PARK HEIGHTS AVE, BALTIMORE, MD 21215-6315
(410) 728-5174
(410) 728-5729
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
21D2112279
MD
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366801466
BEHAVIORAL HEALTH
MD
05
—
411108700
—
MD
Enumeration date
07/14/2017
Last updated
07/21/2022
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