| NPI | 1043706765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONETTE J. DALE Executive Director 662-726-9640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: MS 000000) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2018-07-05 |