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General NPI Number Information
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NPI Number | 1063653715
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Entity Type | Organization
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Legal Business Name | ATLA, LLC
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Dates
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Enumeration Date | 03/10/2009
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Last Update Date | 03/10/2009
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Provider Practice Location Address
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Address Line | 1004 PARADISE RD SUITE #2C
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City | SWAMPSCOTT
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State | MA
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Zip | 01907-1372
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Country | US
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Telephone | 781-592-5787
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Fax |
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Provider Business Mailing Address
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Address Line | 1004 PARADISE RD SUITE #2C
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City | SWAMPSCOTT
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State | MA
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Zip | 01907-1372
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Country | US
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Telephone | 781-592-5787
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | M. KHODY
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Credential |
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Telephone | 781-592-5787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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