Provider Demographics
NPI:1841610698
Name:ENDEAVOUR GROUP LLC.
Entity Type:Organization
Organization Name:ENDEAVOUR GROUP LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANI
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-286-9323
Mailing Address - Street 1:1480 ROUTE 46
Mailing Address - Street 2:STE 359B
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-5910
Mailing Address - Country:US
Mailing Address - Phone:973-286-9323
Mailing Address - Fax:
Practice Address - Street 1:1480 ROUTE 46
Practice Address - Street 2:STE 359B
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-5910
Practice Address - Country:US
Practice Address - Phone:973-286-9323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1283617343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherTIN