Provider Demographics
NPI:1538513718
Name:AISOL WG LLC
Entity Type:Organization
Organization Name:AISOL WG LLC
Other - Org Name:ALL IN SOLUTIONS COUNSELING CENTER WILLOW GROVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
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:561-413-5755
Mailing Address - Street 1:PO BOX 3630
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-0557
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2300 COMPUTER RD
Practice Address - Street 2:SUITE D-21
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1752
Practice Address - Country:US
Practice Address - Phone:267-737-9421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder