| NPI | 1821567991 |
|---|---|
| Doing Business As | PROVIDANCE |
| Entity Type | Organization |
| Authorized Contact | DAVID D SMITH CEO 601-395-7602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172A00000X Driver (Licence: MS 800427553) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: MS 8000427553) |
| 347C00000X Private Vehicle (Licence: MS 098765) | |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2018-11-19 |