Provider Demographics
NPI:1841051976
Name:BORESHA MOBILITY SERVICES LLC
Entity type:Organization
Organization Name:BORESHA MOBILITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LISTONE
Authorized Official - Middle Name:
Authorized Official - Last Name:MWAMBURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-352-4674
Mailing Address - Street 1:1101 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-2737
Mailing Address - Country:US
Mailing Address - Phone:816-352-4674
Mailing Address - Fax:
Practice Address - Street 1:870 W LAYTON ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-6373
Practice Address - Country:US
Practice Address - Phone:913-231-8987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)