Provider Demographics
NPI:1588903785
Name:FARE TO FREEDOM
Entity type:Organization
Organization Name:FARE TO FREEDOM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-826-3273
Mailing Address - Street 1:20000 VICTOR PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-7029
Mailing Address - Country:US
Mailing Address - Phone:855-826-3273
Mailing Address - Fax:734-953-1743
Practice Address - Street 1:20000 VICTOR PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-7029
Practice Address - Country:US
Practice Address - Phone:855-826-3273
Practice Address - Fax:734-953-1743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICE67899343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)