Provider Demographics
NPI:1104292291
Name:MAVEN MOBILITY SERVICES LLC
Entity type:Organization
Organization Name:MAVEN MOBILITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRYHAYES
Authorized Official - Middle Name:E
Authorized Official - Last Name:OSUDUEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-348-0716
Mailing Address - Street 1:13051 LARCHMERE BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1166
Mailing Address - Country:US
Mailing Address - Phone:440-983-0788
Mailing Address - Fax:
Practice Address - Street 1:13051 LARCHMERE BLVD
Practice Address - Street 2:SUITE 307
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44120-1166
Practice Address - Country:US
Practice Address - Phone:440-983-0788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH180025343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)