Organization
STATEWIDE TRANSPORTATION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GERALD MCCLURE (CEO)
(419) 281-0453
Entity
Organization
Contact information
Practice address
969 VIRGINIA AVE, ASHLAND, OH 44805-1949
(419) 281-0453
Mailing address
969 VIRGINIA AVE, ASHLAND, OH 44805-1949
(419) 281-0453
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
347B00000X
Bus
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0148612
—
OH
Enumeration date
10/29/2020
Last updated
10/29/2020
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