Provider Demographics
NPI:1679803944
Name:ASHLEY TRANSPORTATION & HOMECARE SERVICES
Entity type:Organization
Organization Name:ASHLEY TRANSPORTATION & HOMECARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:UMO
Authorized Official - Middle Name:BASSEY
Authorized Official - Last Name:NTEKIM
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, ASW, PHD CAND
Authorized Official - Phone:909-383-4200
Mailing Address - Street 1:1550 N D ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-4720
Mailing Address - Country:US
Mailing Address - Phone:909-383-4200
Mailing Address - Fax:909-383-4208
Practice Address - Street 1:1550 N D ST
Practice Address - Street 2:SUITE D
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4720
Practice Address - Country:US
Practice Address - Phone:909-383-4200
Practice Address - Fax:909-383-4208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)