Provider Demographics
NPI:1851914428
Name:GRACEFUL CHARIOT TRANSPORTING
Entity Type:Organization
Organization Name:GRACEFUL CHARIOT TRANSPORTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GARLAND
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:HENSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:NEMT
Authorized Official - Phone:318-947-5898
Mailing Address - Street 1:308 PERCHERON DR
Mailing Address - Street 2:
Mailing Address - City:GRAND CANE
Mailing Address - State:LA
Mailing Address - Zip Code:71032-6284
Mailing Address - Country:US
Mailing Address - Phone:318-947-5898
Mailing Address - Fax:
Practice Address - Street 1:308 PERCHERON DR
Practice Address - Street 2:
Practice Address - City:GRAND CANE
Practice Address - State:LA
Practice Address - Zip Code:71032-6284
Practice Address - Country:US
Practice Address - Phone:318-947-5898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)