Provider Demographics
NPI:1861409708
Name:ALL GOD'S CHILDREN
Entity type:Organization
Organization Name:ALL GOD'S CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:DANTZLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:850-533-6018
Mailing Address - Street 1:106 RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-9712
Mailing Address - Country:US
Mailing Address - Phone:850-533-6018
Mailing Address - Fax:850-279-4716
Practice Address - Street 1:106 RIDGE LN
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-9712
Practice Address - Country:US
Practice Address - Phone:850-533-6018
Practice Address - Fax:850-279-4716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3378712171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty