Provider Demographics
NPI:1447097985
Name:VENTURA CARE TRANSPORTATION LLC
Entity type:Organization
Organization Name:VENTURA CARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAHEEDAH
Authorized Official - Middle Name:
Authorized Official - Last Name:QAYUUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-227-8117
Mailing Address - Street 1:1177 AZALEA WAY
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-3337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1177 AZALEA WAY
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3337
Practice Address - Country:US
Practice Address - Phone:805-813-5624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle