Provider Demographics
NPI:1730663675
Name:SLALIAGENTLE RIDE TRANSPORTATION INC
Entity Type:Organization
Organization Name:SLALIAGENTLE RIDE TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MKRTCHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-214-5052
Mailing Address - Street 1:11748 OXNARD ST
Mailing Address - Street 2:
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-4720
Mailing Address - Country:US
Mailing Address - Phone:747-214-5052
Mailing Address - Fax:
Practice Address - Street 1:11748 OXNARD ST
Practice Address - Street 2:
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-4720
Practice Address - Country:US
Practice Address - Phone:747-214-5052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)