Provider Demographics
NPI:1336547892
Name:FAMILY TRANS LLC
Entity type:Organization
Organization Name:FAMILY TRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ADDI
Authorized Official - Middle Name:LETICIA
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-500-8051
Mailing Address - Street 1:38 S ROBSON STE 2
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-1344
Mailing Address - Country:US
Mailing Address - Phone:602-500-8051
Mailing Address - Fax:
Practice Address - Street 1:38 S ROBSON STE 2
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-1344
Practice Address - Country:US
Practice Address - Phone:602-500-8051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle