Healthcare Provider Details

I. General information

NPI: 1669382487
Provider Name (Legal Business Name): GRACE WAY NON-EMERGENCY MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15847 STARE ST
NORTH HILLS CA
91343-1422
US

IV. Provider business mailing address

2108 N ST STE N
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 747-330-9677
  • Fax:
Mailing address:
  • Phone: 747-330-9677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ALAN ROJAS
Title or Position: OWNER
Credential:
Phone: 747-330-9677