Healthcare Provider Details

I. General information

NPI: 1184539488
Provider Name (Legal Business Name): HEAVENS GRACE TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 SPRING ST NW APT 118
ATLANTA GA
30309-2898
US

IV. Provider business mailing address

300 PEACHTREE STREET NE STE CS2 #3782
ATLANTA GA
30308
US

V. Phone/Fax

Practice location:
  • Phone: 662-897-8637
  • Fax:
Mailing address:
  • Phone:
  • 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: FRANESHA DAVIS
Title or Position: OWNER
Credential:
Phone: 662-897-8637