Provider Demographics
NPI:1629479589
Name:VALPARAISO INTEGRATED SERVICES, INC.
Entity Type:Organization
Organization Name:VALPARAISO INTEGRATED SERVICES, INC.
Other - Org Name:VALPARAISO INTEGRATED SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NONNA
Authorized Official - Middle Name:I
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-739-5315
Mailing Address - Street 1:P.O. BOX 1368
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-1368
Mailing Address - Country:US
Mailing Address - Phone:231-739-5315
Mailing Address - Fax:231-733-6255
Practice Address - Street 1:3427 FARR ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:FRUITPORT
Practice Address - State:MI
Practice Address - Zip Code:49415
Practice Address - Country:US
Practice Address - Phone:231-739-5315
Practice Address - Fax:231-733-6255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2050343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)