Healthcare Provider Details

I. General information

NPI: 1891615191
Provider Name (Legal Business Name): LACHELSA ALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 8TH AVE
CHICKASAW AL
36611-2004
US

IV. Provider business mailing address

66 8TH AVE
CHICKASAW AL
36611-2004
US

V. Phone/Fax

Practice location:
  • Phone: 251-545-5799
  • Fax:
Mailing address:
  • Phone: 251-513-1235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: