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General NPI Number Information
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NPI Number | 1750225165
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Entity Type | Organization
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Legal Business Name | HAVEN GRACE TRANSPORTATION LLC
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Dates
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Enumeration Date | 04/16/2026
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 1612 GREYFIELD LN
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City | ATLANTA
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State | GA
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Zip | 30350-6338
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Country | US
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Telephone | 786-495-4418
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Fax | 786-495-4418
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Provider Business Mailing Address
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Address Line | 1612 GREYFIELD LN
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City | ATLANTA
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State | GA
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Zip | 30350-6338
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Country | US
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Telephone | 786-495-4418
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Fax | 786-495-4418
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Authorized Official
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Title or Position | OWNER
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Name | JASHONTI NEALY
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Credential | NEALY
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Telephone | 786-495-4418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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