Healthcare Provider Details

I. General information

NPI: 1285586586
Provider Name (Legal Business Name): ROOTED INLIGHT TRANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2026
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 THIMBLE SHOALS BLVD STE 170
NEWPORT NEWS VA
23606-4260
US

IV. Provider business mailing address

733 THIMBLE SHOALS BLVD STE 170
NEWPORT NEWS VA
23606-4260
US

V. Phone/Fax

Practice location:
  • Phone: 804-380-3504
  • Fax: 202-413-8608
Mailing address:
  • Phone: 804-380-3504
  • Fax: 804-380-3504

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: TILAYE KASSAHUN ABATE
Title or Position: OWNER
Credential:
Phone: 804-380-3504