Healthcare Provider Details

I. General information

NPI: 1205743689
Provider Name (Legal Business Name): GARLAND N GRACE TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17669 MCINTYRE ST
DETROIT MI
48219-2369
US

IV. Provider business mailing address

17669 MCINTYRE ST
DETROIT MI
48219-2369
US

V. Phone/Fax

Practice location:
  • Phone: 248-378-7145
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CATRINA MIMS
Title or Position: ADMINISTRATOR
Credential:
Phone: 248-378-7145