Provider Demographics
NPI:1659194942
Name:EDUCATIONAL TRANSPORT COLLABORATIVE, LLC
Entity type:Organization
Organization Name:EDUCATIONAL TRANSPORT COLLABORATIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:LELAND
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:603-748-1340
Mailing Address - Street 1:68 DRINKWATER RD
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4600
Mailing Address - Country:US
Mailing Address - Phone:603-748-1340
Mailing Address - Fax:
Practice Address - Street 1:68 DRINKWATER RD
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4600
Practice Address - Country:US
Practice Address - Phone:603-748-1340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No347E00000XTransportation ServicesTransportation BrokerGroup - Multi-Specialty