Provider Demographics
NPI:1295471175
Name:GRACEFUL TRANSIT CARE LLC
Entity Type:Organization
Organization Name:GRACEFUL TRANSIT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOUNESS
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAWRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-477-4377
Mailing Address - Street 1:8063 CHALLIS RD STE 1032
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-7446
Mailing Address - Country:US
Mailing Address - Phone:313-477-4377
Mailing Address - Fax:
Practice Address - Street 1:8063 CHALLIS RD STE 1032
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-7446
Practice Address - Country:US
Practice Address - Phone:313-477-4377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)