Provider Demographics
NPI:1154809291
Name:FRANCIS, ALICE ARLENE
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:ARLENE
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S EUSTIS ST APT 7
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-4176
Mailing Address - Country:US
Mailing Address - Phone:386-517-3154
Mailing Address - Fax:
Practice Address - Street 1:120 N CENTER ST,
Practice Address - Street 2:7
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-3272
Practice Address - Country:US
Practice Address - Phone:386-517-3154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician