Provider Demographics
NPI:1659782506
Name:DIFFERENT ABILITIES TRANSPORTATION AND CARE
Entity Type:Organization
Organization Name:DIFFERENT ABILITIES TRANSPORTATION AND CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENAE
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-833-9407
Mailing Address - Street 1:190 OVERMONT AVE SW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-3872
Mailing Address - Country:US
Mailing Address - Phone:330-705-1472
Mailing Address - Fax:
Practice Address - Street 1:1612 TUSCARAWAS ST W
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-4847
Practice Address - Country:US
Practice Address - Phone:330-705-1472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251C00000X
OH3433900000X343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251C00000XAgenciesDay Training, Developmentally Disabled Services