Provider Demographics
NPI:1609931898
Name:JASPER COUNTY COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:JASPER COUNTY COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-866-8071
Mailing Address - Street 1:967 E LEOPOLD ST
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:IN
Mailing Address - Zip Code:47978-2916
Mailing Address - Country:US
Mailing Address - Phone:219-866-8071
Mailing Address - Fax:219-866-5653
Practice Address - Street 1:967 E LEOPOLD ST
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:IN
Practice Address - Zip Code:47978-2916
Practice Address - Country:US
Practice Address - Phone:219-866-8071
Practice Address - Fax:219-866-5653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)