Provider Demographics
NPI:1013634294
Name:PSYCO KULTURE, LLC
Entity Type:Organization
Organization Name:PSYCO KULTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:THEDFORD
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:JONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:559-421-0291
Mailing Address - Street 1:8050 N PALM AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-5510
Mailing Address - Country:US
Mailing Address - Phone:559-421-0291
Mailing Address - Fax:
Practice Address - Street 1:8050 N PALM AVE STE 300
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-5510
Practice Address - Country:US
Practice Address - Phone:559-421-0291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker