Organization
GREEN LIGHTS AZ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHA MAYTA (MANAGER)
(623) 418-1234
Entity
Organization
Contact information
Practice address
15600 N BLACK CANYON HWY STE C107, PHOENIX, AZ 85053-4055
(623) 418-1234
Mailing address
15600 N BLACK CANYON HWY STE C107, PHOENIX, AZ 85053-4055
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
05/01/2023
Last updated
05/05/2023
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