Provider Demographics
NPI:1609000330
Name:AFFORDABLE COMMUNITY TRANSPORTATION
Entity Type:Organization
Organization Name:AFFORDABLE COMMUNITY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:WORLOBAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-391-1746
Mailing Address - Street 1:9799 VALLEY FORGE LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-3701
Mailing Address - Country:US
Mailing Address - Phone:763-391-1746
Mailing Address - Fax:763-391-9406
Practice Address - Street 1:9799 VALLEY FORGE LN N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-3701
Practice Address - Country:US
Practice Address - Phone:763-391-1746
Practice Address - Fax:763-391-9406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-09
Last Update Date:2009-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN374612343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)