Provider Demographics
NPI:1093127003
Name:GOOD DIRECTION TRANSPORTATION
Entity Type:Organization
Organization Name:GOOD DIRECTION TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-212-9218
Mailing Address - Street 1:23750 ALESSANDRO BLVD STE L104
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-8813
Mailing Address - Country:US
Mailing Address - Phone:951-212-9218
Mailing Address - Fax:
Practice Address - Street 1:23750 ALESSANDRO BLVD STE L104
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-8813
Practice Address - Country:US
Practice Address - Phone:951-212-9218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERRY CARE SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-25
Last Update Date:2014-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)