Provider Demographics
NPI: | 1063968907 |
---|---|
Name: | ALL IN MEDICAL LLC |
Entity type: | Organization |
Organization Name: | ALL IN MEDICAL LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CFO/OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CASEY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LIDLOW |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 610-937-5385 |
Mailing Address - Street 1: | 1325 S CONGRESS AVE |
Mailing Address - Street 2: | SUITE 203 |
Mailing Address - City: | BOYNTON BEACH |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33426-5876 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1325 S CONGRESS AVE |
Practice Address - Street 2: | SUITE 203 |
Practice Address - City: | BOYNTON BEACH |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33426-5876 |
Practice Address - Country: | US |
Practice Address - Phone: | 610-937-5385 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-08-31 |
Last Update Date: | 2016-08-31 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | SW 4814 | 1041C0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |