Organization
A FULLER LIFESTYLE GROUP HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORENZO JAMES FULLER (PRESIDENT)
(904) 894-9979
Entity
Organization
Contact information
Practice address
8567 CHERYL ANN LN, JACKSONVILLE, FL 32244-1272
(904) 894-9979
(904) 894-9979
Mailing address
4349 BOAT CLUB DR, JACKSONVILLE, FL 32277-1202
(904) 894-9979
(904) 894-9979
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
02/19/2026
Last updated
02/19/2026
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