Organization
COMMUNITY CHOICE TRASNPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIDRE LAURENT (CEO)
(602) 672-6550
Entity
Organization
Contact information
Practice address
4480 W PEORIA AVE STE 108, GLENDALE, AZ 85302-2022
(602) 922-0662
Mailing address
4480 W PEORIA AVE STE 108, GLENDALE, AZ 85302-2022
(602) 922-0662
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
04/19/2023
Last updated
04/19/2023
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