| NPI | 1629872809 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | RIDGE WILSON Owner/Manager 502-416-6903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2025-04-04 |
| Last Update Date | 2025-04-04 |