Provider Demographics
NPI:1447405881
Name:FULFILLING A NEED,LLC
Entity Type:Organization
Organization Name:FULFILLING A NEED,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:D
Authorized Official - Last Name:DYSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-605-1005
Mailing Address - Street 1:1427 69TH ST
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53143-5346
Mailing Address - Country:US
Mailing Address - Phone:262-605-1005
Mailing Address - Fax:262-605-8969
Practice Address - Street 1:1427 69TH ST
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53143-5346
Practice Address - Country:US
Practice Address - Phone:262-605-1005
Practice Address - Fax:262-605-8969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WID2507646554703343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)