Provider Demographics
NPI:1710416060
Name:SQUEECE SERVICES LLC
Entity Type:Organization
Organization Name:SQUEECE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FLORENTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:404-883-8948
Mailing Address - Street 1:2304 OAK LN DR SUITE 201
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051
Mailing Address - Country:US
Mailing Address - Phone:404-883-8948
Mailing Address - Fax:972-767-3338
Practice Address - Street 1:2304 OAK LN DR SUITE 201
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051
Practice Address - Country:US
Practice Address - Phone:404-883-8948
Practice Address - Fax:972-767-3338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-09
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle