Provider Demographics
NPI:1083971154
Name:ALL 4 ONE, LLC
Entity Type:Organization
Organization Name:ALL 4 ONE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NERISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-671-8169
Mailing Address - Street 1:6034 DEEP GREEN DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-8792
Mailing Address - Country:US
Mailing Address - Phone:704-671-8169
Mailing Address - Fax:
Practice Address - Street 1:6034 DEEP GREEN DR
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-8792
Practice Address - Country:US
Practice Address - Phone:704-671-8169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health