Provider Demographics
NPI:1215479605
Name:GREEN LEAF TRANSPORTATION SERVICES LLC
Entity type:Organization
Organization Name:GREEN LEAF TRANSPORTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:QUINN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-258-4487
Mailing Address - Street 1:1750 HARBOR DR APT 315
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-9309
Mailing Address - Country:US
Mailing Address - Phone:504-258-4487
Mailing Address - Fax:
Practice Address - Street 1:1750 HARBOR DR APT 315
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-9309
Practice Address - Country:US
Practice Address - Phone:504-258-4487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)