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General NPI Number Information
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NPI Number | 1780594200
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Entity Type | Organization
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Legal Business Name | MANTRA GROUP HOME LLC
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Dates
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Enumeration Date | 09/08/2026
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Last Update Date | 09/08/2026
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Provider Practice Location Address
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Address Line | 5420 W GLASS LN
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City | LAVEEN
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State | AZ
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Zip | 85339-6943
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Country | US
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Telephone | 602-312-6379
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Fax | 866-553-9252
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Provider Business Mailing Address
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Address Line | 5420 W GLASS LN
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City | LAVEEN
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State | AZ
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Zip | 85339-6943
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Country | US
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Telephone | 602-312-6379
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Fax | 866-553-9252
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Authorized Official
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Title or Position | OWNER
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Name | ASLI HUSSEIN
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Credential |
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Telephone | 602-312-6379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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