Provider Demographics
NPI:1194371674
Name:ALL.WALKS.THRU.LIFE LLC
Entity Type:Organization
Organization Name:ALL.WALKS.THRU.LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PAULSHAUNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FUGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-619-9321
Mailing Address - Street 1:4138 VAHAN CT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-6838
Mailing Address - Country:US
Mailing Address - Phone:888-741-6180
Mailing Address - Fax:877-561-6971
Practice Address - Street 1:4138 VAHAN CT
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-6838
Practice Address - Country:US
Practice Address - Phone:888-741-6180
Practice Address - Fax:877-561-6971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-12
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA90934505AMedicaid