Provider Demographics
NPI:1447857792
Name:DALES NON EMERGENCY TRANSPORTATION INC
Entity type:Organization
Organization Name:DALES NON EMERGENCY TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHIKETA
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY-DALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-539-9092
Mailing Address - Street 1:1015 E DALLAS ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2029
Mailing Address - Country:US
Mailing Address - Phone:817-539-9092
Mailing Address - Fax:817-704-3188
Practice Address - Street 1:1015 E DALLAS ST STE 2
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2029
Practice Address - Country:US
Practice Address - Phone:817-539-9092
Practice Address - Fax:817-704-3188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)