Provider Demographics
NPI:1790320778
Name:ADAPTIVE ACCOMMODATIONS RESIDENTIAL
Entity Type:Organization
Organization Name:ADAPTIVE ACCOMMODATIONS RESIDENTIAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:COTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-386-4018
Mailing Address - Street 1:4016 MACARTHUR AVE APT B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-4058
Mailing Address - Country:US
Mailing Address - Phone:804-386-4018
Mailing Address - Fax:
Practice Address - Street 1:4016 MACARTHUR AVE APT B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-4058
Practice Address - Country:US
Practice Address - Phone:804-386-4018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)