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General NPI Number Information
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NPI Number | 1861207326
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Entity Type | Organization
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Legal Business Name | HEALING HAVEN TRANSPORT SERVICES LLC
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 1344 GRAND TETON DR
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City | DESOTO
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State | TX
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Zip | 75115-2939
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Country | US
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Telephone | 703-554-7829
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Fax | 469-397-0779
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Provider Business Mailing Address
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Address Line | 1344 GRAND TETON DR
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City | DESOTO
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State | TX
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Zip | 75115-2939
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Country | US
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Telephone | 703-554-7829
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Fax | 469-397-0779
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MABEL NIKOI
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Credential |
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Telephone | 703-554-7829
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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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Taxonomy #2
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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