Provider Demographics
NPI:1316004658
Name:AVISINA
Entity Type:Organization
Organization Name:AVISINA
Other - Org Name:MOBILITY PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TALAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SABRAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-588-2403
Mailing Address - Street 1:2251 BAILEY ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2442
Mailing Address - Country:US
Mailing Address - Phone:313-633-0674
Mailing Address - Fax:313-633-0674
Practice Address - Street 1:2251 BAILEY ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2442
Practice Address - Country:US
Practice Address - Phone:313-633-0674
Practice Address - Fax:313-633-0674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)