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General NPI Number Information
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NPI Number | 1659782506
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Entity Type | Organization
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Legal Business Name | DIFFERENT ABILITIES TRANSPORTATION AND CARE
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Dates
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Enumeration Date | 05/14/2014
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Last Update Date | 05/14/2014
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Provider Practice Location Address
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Address Line | 1612 TUSCARAWAS ST W
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City | CANTON
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State | OH
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Zip | 44708-4847
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Country | US
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Telephone | 330-705-1472
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Fax |
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Provider Business Mailing Address
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Address Line | 190 OVERMONT AVE SW
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City | MASSILLON
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State | OH
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Zip | 44646-3872
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Country | US
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Telephone | 330-705-1472
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JENAE ASHLEY STEPHENS
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Credential |
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Telephone | 330-833-9407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 3433900000X
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License Number State | OH
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