Provider Demographics
NPI:1841742988
Name:YOUTH TRANSIT AUTHORITY, LLC
Entity Type:Organization
Organization Name:YOUTH TRANSIT AUTHORITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIOVINO
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:717-599-0452
Mailing Address - Street 1:188 BLUE JAY WAY
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-8848
Mailing Address - Country:US
Mailing Address - Phone:717-599-0452
Mailing Address - Fax:
Practice Address - Street 1:188 BLUE JAY WAY
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-8848
Practice Address - Country:US
Practice Address - Phone:717-599-0452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6410565343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1027018Medicaid