| NPI | 1821761990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IKISHIA NATAYE JACKSON Administrator/ Owner 267-439-0966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 332U00000X Home Delivered Meals | |
| 342000000X | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2021-07-26 |