Organization
DE-TRANS LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARYL FITZGERALD (OWNER)
(804) 491-6665
Entity
Organization
Contact information
Practice address
927 JENKINS CHURCH RD, CUMBERLAND, VA 23040-2036
(804) 491-6665
Mailing address
927 JENKINS CHURCH RD, CUMBERLAND, VA 23040-2036
(804) 491-6665
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
T67507941
VA
Other
Enumeration date
03/22/2017
Last updated
11/20/2020
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