Organization
EXTRAORDINARY LUXURY RIDES
Active
Organization
EXTRAORDINARY LUXURY RIDES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ADDIE LEE HENTION (CO-CEO/DIRECTOR)
(470) 618-2890
Entity
Organization
Contact information
Practice address
5744 SOUTHLAND WALK, STONE MOUNTAIN, GA 30087-5291
(470) 618-2890
Mailing address
5744 SOUTHLAND WALK, STONE MOUNTAIN, GA 30087-5291
(470) 618-2890
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
347E00000X
Transportation Broker
—
—
Other
Enumeration date
02/21/2023
Last updated
02/21/2023
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