| NPI | 1063003820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMPA YVETTE WILLIAMS Member Manager 318-990-8276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2021-02-03 |
| Last Update Date | 2021-11-24 |