Organization
DANCEFIT.LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANITRA KENNEDY JARREAU LPN (CO-OWNER/INSTRUCTOR)
(251) 281-2110
Entity
Organization
Contact information
Practice address
1717 DAUPHIN ST, MOBILE, AL 36604-1307
(251) 281-2110
(251) 330-1727
Mailing address
PO BOX 6223, MOBILE, AL 36660-0223
(251) 281-2110
(251) 330-1727
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
AL
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02022009
BLUE CROSS BLUE SHEILD
—
05
—
2209
—
AL
Enumeration date
04/30/2009
Last updated
04/30/2009
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