Healthcare Provider Details

I. General information

NPI: 1134044860
Provider Name (Legal Business Name): LEGACY CARE TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 WALL BLVD
GRETNA LA
70056-7768
US

IV. Provider business mailing address

500 WALL BLVD PT E 131
GREAT LA
70056
US

V. Phone/Fax

Practice location:
  • Phone: 504-357-8808
  • Fax:
Mailing address:
  • Phone: 504-357-8808
  • 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: LAITH BASIM ABED ALJAWAD
Title or Position: MANAGER
Credential:
Phone: 504-357-8808