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General NPI Number Information
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NPI Number | 1609000330
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Entity Type | Organization
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Legal Business Name | AFFORDABLE COMMUNITY TRANSPORTATION
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Dates
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Enumeration Date | 05/09/2009
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Last Update Date | 05/09/2009
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Provider Practice Location Address
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Address Line | 9799 VALLEY FORGE LN N
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City | MAPLE GROVE
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State | MN
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Zip | 55369-3701
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Country | US
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Telephone | 763-391-1746
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Fax | 763-391-9406
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Provider Business Mailing Address
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Address Line | 9799 VALLEY FORGE LN N
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City | MAPLE GROVE
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State | MN
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Zip | 55369-3701
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Country | US
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Telephone | 763-391-1746
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Fax | 763-391-9406
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Authorized Official
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Title or Position | FOUNDER/PRESIDENT
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Name | MR. JAMES S. WORLOBAH
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Credential |
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Telephone | 763-391-1746
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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 | 374612
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License Number State | MN
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