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General NPI Number Information
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NPI Number | 1912833773
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Entity Type | Organization
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Legal Business Name | GRACE MOBILITY
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Dates
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Enumeration Date | 06/19/2026
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Last Update Date | 06/19/2026
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Provider Practice Location Address
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Address Line | 115 CHERRY ST APT B
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City | EVANSVILLE
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State | IN
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Zip | 47713-1019
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Country | US
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Telephone | 812-568-0548
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Fax |
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Provider Business Mailing Address
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Address Line | 115 CHERRY ST APT B
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City | EVANSVILLE
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State | IN
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Zip | 47713-1019
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Country | US
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Telephone | 812-568-0548
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BRIAN MATTINGLY
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Credential |
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Telephone | 812-568-0548
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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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