Provider Demographics
NPI:1609687367
Name:ALL INCLUDED LLC
Entity type:Organization
Organization Name:ALL INCLUDED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:MONET VICTORIA
Authorized Official - Last Name:KEATON-SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-604-3036
Mailing Address - Street 1:1372 WALSHIRE DR N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-8510
Mailing Address - Country:US
Mailing Address - Phone:614-604-3036
Mailing Address - Fax:
Practice Address - Street 1:1372 WALSHIRE DR N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-8510
Practice Address - Country:US
Practice Address - Phone:614-604-3036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH77616011Medicaid