Provider Demographics
NPI:1215772751
Name:G&T COLLECTIVE LLC
Entity type:Organization
Organization Name:G&T COLLECTIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-645-5156
Mailing Address - Street 1:2010 HEATHERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-3048
Mailing Address - Country:US
Mailing Address - Phone:512-645-5156
Mailing Address - Fax:
Practice Address - Street 1:2010 HEATHERBROOK DR
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3048
Practice Address - Country:US
Practice Address - Phone:512-645-5156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:G&T COLLECTIVE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)