Provider Demographics
NPI:1134873201
Name:ALLIE ROSE TRANSPORTATION AND SERVICES LLC
Entity type:Organization
Organization Name:ALLIE ROSE TRANSPORTATION AND SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LATIKKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-768-4442
Mailing Address - Street 1:4003 WILD SENNA BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-6933
Mailing Address - Country:US
Mailing Address - Phone:708-268-0870
Mailing Address - Fax:
Practice Address - Street 1:4003 WILD SENNA BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-6933
Practice Address - Country:US
Practice Address - Phone:708-268-0870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency