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General NPI Number Information
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NPI Number | 1558634113
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Entity Type | Organization
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Legal Business Name | A.L.L. FOCUS INC
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Dates
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Enumeration Date | 02/13/2012
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 11115 KEY HAVEN BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32218-4488
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Country | US
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Telephone | 904-329-1027
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Fax | 904-212-0082
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Provider Business Mailing Address
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Address Line | 2005 BROWARD RD
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City | JACKSONVILLE
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State | FL
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Zip | 32218-5323
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Country | US
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Telephone | 904-329-1027
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Fax | 904-212-0082
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ANTWAN LEWEY
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Credential | BA
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Telephone | 904-537-0599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 100019473
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License Number State | FL
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