Provider Demographics
NPI:1154500965
Name:JA.CORP
Entity Type:Organization
Organization Name:JA.CORP
Other - Org Name:PRECIOUS HEARTS TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:
Authorized Official - Last Name:CACHURIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-402-1510
Mailing Address - Street 1:PO BOX 1162
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95776-1162
Mailing Address - Country:US
Mailing Address - Phone:530-402-1510
Mailing Address - Fax:530-668-8949
Practice Address - Street 1:791 EAST ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95776-4144
Practice Address - Country:US
Practice Address - Phone:530-415-8118
Practice Address - Fax:530-668-8949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATD2007-11343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)