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Organization

SAFARI OAKS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARTIN AGONGO (MANAGER)
(214) 924-5283
Entity
Organization

Contact information

Practice address
6310 S STATE HIGHWAY 360 APT 1232, GRAND PRAIRIE, TX 75052-8706
(214) 924-5283
Mailing address
PO BOX 492, MANSFIELD, TX 76063-0137

Taxonomy

Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary
343900000X
Non-emergency Medical Transport (VAN)
347C00000X
Private Vehicle

Other

Enumeration date
07/11/2025
Last updated
07/30/2025
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