| Innovative Care Network | |
|
120 Capcom Ave Ste 102c Wake Forest NC 27587-6537 | |
| (215) 279-1509 | |
| Not Available |
| Full Name | Innovative Care Network |
|---|---|
| Speciality | Behavior Technician |
| Location | 120 Capcom Ave Ste 102c, Wake Forest, North Carolina |
| Authorized Official Name and Position | Kianna L Chapman (CEO/OWNER) |
| Authorized Official Contact | 2152791509 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Care Network 120 Capcom Ave Ste 102c Wake Forest NC 27587-6537 Ph: (215) 279-1509 | Innovative Care Network 120 Capcom Ave Ste 102c Wake Forest NC 27587-6537 Ph: (215) 279-1509 |
| NPI Number | 1780140798 |
|---|---|
| Provider Enumeration Date | 02/14/2019 |
| Last Update Date | 01/17/2024 |
| Certification Date | 01/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780140798 | NPI | - | NPPES |
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