Provider Demographics
NPI:1013186444
Name:MONROE COUNTY OPPORTUNITY PROGRAM
Entity Type:Organization
Organization Name:MONROE COUNTY OPPORTUNITY PROGRAM
Other - Org Name:MCOP
Other - Org Type:Other Name
Authorized Official - Title/Position:SPEICALIZED TRANSPORTATION DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:IACOANGELI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-241-2783
Mailing Address - Street 1:1140 S TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-4006
Mailing Address - Country:US
Mailing Address - Phone:734-241-2783
Mailing Address - Fax:734-457-0630
Practice Address - Street 1:1140 S TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-4006
Practice Address - Country:US
Practice Address - Phone:734-241-2783
Practice Address - Fax:734-457-0630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMICS6314343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)