Organization
INNOVATIVE CARE NETWORK LLC
Active
Other names
Innovative Care Network
Organization subpart
No
Provider details
NPI number
Authorized official
KIANNA L CHAPMAN (CEO/OWNER)
(215) 279-1509
Entity
Organization
Contact information
Practice address
120 CAPCOM AVE STE 102C, WAKE FOREST, NC 27587-6537
(215) 279-1509
Mailing address
120 CAPCOM AVE STE 102C, WAKE FOREST, NC 27587-6537
(215) 279-1509
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
172A00000X
Driver
—
—
251S00000X
Community/Behavioral Health Agency
—
—
372600000X
Adult Companion
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
02/14/2019
Last updated
01/17/2024
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