Healthcare Provider Details

I. General information

NPI: 1982516027
Provider Name (Legal Business Name): TAKING IT TO THE STREETS OUTREACH LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6532 ROSE AVE
LONG BEACH CA
90805
US

IV. Provider business mailing address

14910 PERRIS BLVD STE B
MORENO VALLEY CA
92553-7181
US

V. Phone/Fax

Practice location:
  • Phone: 800-836-1479
  • Fax: 800-836-1479
Mailing address:
  • Phone:
  • Fax: 800-836-1479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. MERCIDA DEMPS
Title or Position: CEO
Credential:
Phone: 562-482-7364