| NPI | 1972137321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TENESICA DESHOUS BOLDING Adminstrator 423-629-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |