Organization
JOHNNY CARES INC
Active
Parent organization
JOHNNY CARES INC
Other names
Waverly Health & Fitness Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
JOHNNY CARES 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
(410) 467-5944
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
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/17/2015
Last updated
04/17/2015
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