Organization
BLAZE COMMUNITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT ALLAN DAVIS (PRESIDENT)
(937) 409-1209
Entity
Organization
Contact information
Practice address
136 E. SPRING ST., CLAYTON, OH 45315
(937) 409-1209
Mailing address
PO BOX 165, CLAYTON, OH 45315-0165
(937) 409-1209
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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