| NPI | 1013501964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE STACKHOUSE Owner/Member/Employee 309-310-2301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2021-02-22 |