Organization
REVIVAL TRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY NICOLE ELLIOTT (TRANSPORTATION PROVIDER)
(707) 376-5086
Entity
Organization
Contact information
Practice address
521 CAPPS LN, UKIAH, CA 95482-7227
(707) 376-5086
Mailing address
521 CAPPS LN, UKIAH, CA 95482-7227
(707) 376-5086
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
06/04/2024
Last updated
07/30/2024
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