Provider Demographics
NPI:1972348316
Name:GRATITUDE CARE & LOGISTIC LLC
Entity type:Organization
Organization Name:GRATITUDE CARE & LOGISTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GAELLE
Authorized Official - Middle Name:N
Authorized Official - Last Name:TCHOUMBA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-646-2404
Mailing Address - Street 1:7782 NORTHROP DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-6085
Mailing Address - Country:US
Mailing Address - Phone:909-758-2840
Mailing Address - Fax:951-776-8739
Practice Address - Street 1:7782 NORTHROP DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-6085
Practice Address - Country:US
Practice Address - Phone:909-758-2840
Practice Address - Fax:951-776-8739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)