Provider Demographics
NPI:1114439676
Name:CITY TRANSPORT LLC
Entity Type:Organization
Organization Name:CITY TRANSPORT LLC
Other - Org Name:CITY COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN OF THE BOARD
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:BUMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-766-3807
Mailing Address - Street 1:P.O. BOX 387
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72203
Mailing Address - Country:US
Mailing Address - Phone:501-236-6019
Mailing Address - Fax:501-286-6089
Practice Address - Street 1:104 N 1ST ST
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-3075
Practice Address - Country:US
Practice Address - Phone:501-286-6019
Practice Address - Fax:501-286-6089
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY TRANSPORT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)