| NPI | 1952176398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKY RONDELL WILSON Director/Operator 860-280-6476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2023-11-17 |