Provider Demographics
NPI:1811528284
Name:RELAX RIDE LLC
Entity type:Organization
Organization Name:RELAX RIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARIK
Authorized Official - Middle Name:ABDALLAH
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-328-9450
Mailing Address - Street 1:12 WILCOX ST FL 2
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-1250
Mailing Address - Country:US
Mailing Address - Phone:860-328-9450
Mailing Address - Fax:
Practice Address - Street 1:12 WILCOX ST FL 2
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-1250
Practice Address - Country:US
Practice Address - Phone:860-328-9450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT3653OtherGENERAL LIVERY SERVICE