Provider Demographics
NPI:1831379924
Name:ALL ABOUT U
Entity type:Organization
Organization Name:ALL ABOUT U
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CLORISSAL
Authorized Official - Middle Name:RENEL
Authorized Official - Last Name:ALCANTARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-246-1141
Mailing Address - Street 1:7411 CHERRY BLOSSOM WAY
Mailing Address - Street 2:
Mailing Address - City:WINSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30187-2069
Mailing Address - Country:US
Mailing Address - Phone:404-246-1141
Mailing Address - Fax:
Practice Address - Street 1:7411 CHERRY BLOSSOM WAY
Practice Address - Street 2:
Practice Address - City:WINSTON
Practice Address - State:GA
Practice Address - Zip Code:30187-2069
Practice Address - Country:US
Practice Address - Phone:404-246-1141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA621610302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization