| NPI | 1245826874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM RENA CALLICUTT Administrator 870-636-9593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2020-12-17 |