Provider Demographics
NPI:1558505727
Name:ACCLAIM MOBILITY LLC
Entity Type:Organization
Organization Name:ACCLAIM MOBILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:DUCKETT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:916-682-0952
Mailing Address - Street 1:9417 CORLEY COVE LN
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-4801
Mailing Address - Country:US
Mailing Address - Phone:916-682-0952
Mailing Address - Fax:888-977-8861
Practice Address - Street 1:9417 CORLEY COVE LN
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-4801
Practice Address - Country:US
Practice Address - Phone:916-682-0952
Practice Address - Fax:888-977-8861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)