Charles Lawrence Allen, Inc. | |
1121 Nikki View Dr Brandon FL 33511-4879 | |
(813) 230-9248 | |
(812) 657-1049 |
Full Name | Charles Lawrence Allen, Inc. |
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Speciality | Community/behavioral Health |
Location | 1121 Nikki View Dr, Brandon, Florida |
Authorized Official Name and Position | Charles Allen (PRESIDENT) |
Authorized Official Contact | 8132309248 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Charles Lawrence Allen, Inc. Po Box 6908 Brandon FL 33508-6015 Ph: (813) 230-9248 | Charles Lawrence Allen, Inc. 1121 Nikki View Dr Brandon FL 33511-4879 Ph: (813) 230-9248 |
NPI Number | 1467723890 |
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Provider Enumeration Date | 01/17/2012 |
Last Update Date | 01/17/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467723890 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | SW3296 (Florida) | Primary |
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