Provider Demographics
NPI:1134935463
Name:FAMILY AFFAIR TRANSPORTATION SERVICES LLC
Entity type:Organization
Organization Name:FAMILY AFFAIR TRANSPORTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FIELDS MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-310-4419
Mailing Address - Street 1:503 PUNAHOU ST
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-1631
Mailing Address - Country:US
Mailing Address - Phone:626-786-1253
Mailing Address - Fax:
Practice Address - Street 1:503 PUNAHOU ST
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-1631
Practice Address - Country:US
Practice Address - Phone:626-786-1253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)