| NPI | 1013266741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISMAEL MANUEL MEDINA Member/Manager 208-750-8726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2012-09-10 |