| NPI | 1922485630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JACKSON Director 469-513-4064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347C00000X Private Vehicle |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2015-05-11 |