Healthcare Provider Details

I. General information

NPI: 1881541225
Provider Name (Legal Business Name): HARBORGROVE CARE&MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6023 S MANZANITA WAY
BOISE ID
83709-4062
US

IV. Provider business mailing address

6023 S MANZANITA WAY
BOISE ID
83709-4062
US

V. Phone/Fax

Practice location:
  • Phone: 208-206-0694
  • Fax:
Mailing address:
  • Phone: 208-206-0694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MUBAREK WESLEY HAWS
Title or Position: OWNER
Credential:
Phone: 208-206-0694