| NPI | 1477791788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELORES KOONCE Member 219-696-6718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347B00000X Bus |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2009-01-23 |