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General NPI Number Information
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NPI Number | 1568217594
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Entity Type | Organization
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Legal Business Name | BRANCHING OUT FOR BETTER
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 10821 S HALE AVE
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City | CHICAGO
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State | IL
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Zip | 60643-3335
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Country | US
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Telephone | 773-851-1709
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Fax |
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Provider Business Mailing Address
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Address Line | 9449 S KEDZIE AVE # 206
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City | EVERGREEN PK
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State | IL
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Zip | 60805-2325
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | BAKKAH AL-NURRIDIN DANTZLER
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Credential |
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Telephone | 773-996-1598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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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 | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #3
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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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