Provider Demographics
NPI:1912573437
Name:MTB HOLDINGS LLC
Entity Type:Organization
Organization Name:MTB HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONTASSER
Authorized Official - Middle Name:
Authorized Official - Last Name:JABBAR
Authorized Official - Suffix:
Authorized Official - Credentials:NEMT PROVIDER
Authorized Official - Phone:318-581-3398
Mailing Address - Street 1:2428 ENGLAND DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-4126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2428 ENGLAND DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-4126
Practice Address - Country:US
Practice Address - Phone:318-581-3398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty