Organization
ICAN HEALTH CARE & SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISAIAH BANKOLE (COE/CO-OWNER)
(602) 622-2618
Entity
Organization
Contact information
Practice address
4225 W GLENDALE AVE, SUITE A-100/101, PHOENIX, AZ 85051-8194
(480) 851-8323
(623) 207-9564
Mailing address
4225 W GLENDALE AVE, STE A-100/101, PHOENIX, AZ 85051-8194
(480) 851-8323
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/25/2022
Last updated
11/10/2022
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