Provider Demographics
NPI:1073219291
Name:FRIENDLY AND FAMILY TRANSPORTATION LLC
Entity Type:Organization
Organization Name:FRIENDLY AND FAMILY TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DRIVER
Authorized Official - Prefix:
Authorized Official - First Name:LAKEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-628-8498
Mailing Address - Street 1:1953 N 38TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-1806
Mailing Address - Country:US
Mailing Address - Phone:414-628-8498
Mailing Address - Fax:
Practice Address - Street 1:1953 N 38TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-1806
Practice Address - Country:US
Practice Address - Phone:414-628-8498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)