| NPI | 1053828376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEVAN JERMAINE HENTON MORAN Owner 318-792-8117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2018-01-09 |