Provider Demographics
NPI:1427894906
Name:PRO SAHARA LLC
Entity type:Organization
Organization Name:PRO SAHARA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUMUYIWA
Authorized Official - Middle Name:ISHOLA
Authorized Official - Last Name:FADAHUNSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-703-1375
Mailing Address - Street 1:1153 BERGEN ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-2201
Mailing Address - Country:US
Mailing Address - Phone:862-703-1375
Mailing Address - Fax:
Practice Address - Street 1:1153 BERGEN ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2201
Practice Address - Country:US
Practice Address - Phone:862-703-1375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management