Healthcare Provider Details

I. General information

NPI: 1528875663
Provider Name (Legal Business Name): RIIIDE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2024
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

953 BEACONSFIELD AVE APT 1
GROSSE POINTE PARK MI
48230-1796
US

IV. Provider business mailing address

953 BEACONSFIELD AVE APT 1
GROSSE POINTE PARK MI
48230-1796
US

V. Phone/Fax

Practice location:
  • Phone: 313-209-1836
  • Fax:
Mailing address:
  • Phone: 313-209-1836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. BRENDA YVETTE ALLEN
Title or Position: OWNER
Credential:
Phone: 313-209-1836