Provider Demographics
NPI:1154016145
Name:ALTHEA ENTERPRISE, LLC.
Entity type:Organization
Organization Name:ALTHEA ENTERPRISE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:QUINTERO
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-470-9646
Mailing Address - Street 1:5050 PALO VERDE ST STE L1035050
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2329
Mailing Address - Country:US
Mailing Address - Phone:909-470-9646
Mailing Address - Fax:
Practice Address - Street 1:5050 PALO VERDE ST STE L1035050
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2329
Practice Address - Country:US
Practice Address - Phone:909-470-9646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)