MEDICARE: NOLAS TRAVELING WITH GRACE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1619582079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOLAS TRAVELING WITH GRACE LLC

Provider Business Mailing Address
First Line	:	1141 FREMAUX AVE
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70458-3537
Country	:	US
Telephone Number	:	985-445-2323
Fax Number	:

Provider Business Practice Location Address
First Line	:	1141 FREMAUX AVE
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70458-3537
Country	:	US
Telephone Number	:	985-445-2323
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	APRIL JONES
Credential	:
Telephone Number	:	985-445-2323

Provider Enumeration Date	:	09/12/2020
Last Update Date	:	12/15/2025

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