MEDICARE: GREEN SUPPORTIVE CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1164976700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREEN SUPPORTIVE CARE

Provider Business Mailing Address
First Line	:	708 E SHARPNACK ST
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19119-1535
Country	:	US
Telephone Number	:	215-528-2926
Fax Number	:

Provider Business Practice Location Address
First Line	:	708 E SHARPNACK ST
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19119-1535
Country	:	US
Telephone Number	:	215-528-2926
Fax Number	:

Authorized Official
Title or Position	:	MEMBER-LLC
Name	:	SHARDAI GREEN
Credential	:
Telephone Number	:	215-528-2926

Provider Enumeration Date	:	08/11/2016
Last Update Date	:	08/11/2016

Similar Medicare Providers

1285017251 — SHERRY GREEN MSW, LBS
Practice Location Address:

708 E SHARPNACK ST
PHILADELPHIA, PA
19119-1535

Practice Phone: 215-528-2927
Practice Fax:

1740737055 — MOTHER CARE INC
Practice Location Address:

708 E SHARPNACK ST
PHILADELPHIA, PA
19119-1535

Practice Phone: 215-528-2927
Practice Fax: 267-766-2992

1487707006 — DR. VALDEA DELANO JENNINGS ED.D
Practice Location Address:

333 W MOUNT AIRY AVE
PHILA, PA
19119-2941

Practice Phone: 215-248-5228
Practice Fax:

1023164134 — MS. CATALINA BAUTISTA
Practice Location Address:

7228 GERMANTOWN AVE
PHILA, PA
19119-1724

Practice Phone: 215-248-6070
Practice Fax: 215-248-2410

1447498837 — MOTHER CARE INC.
Practice Location Address:

6423 CLEARVIEW ST
PHILA, PA
19119-2041

Practice Phone: 215-528-2927
Practice Fax: 215-657-4387

1568726156 — MR. LEVIS WAYNE KENNEY LPC
Practice Location Address:

325 E UPSAL ST
PHILA, PA
19119-2348

Practice Phone: 215-668-6446
Practice Fax:

Directions to “GREEN SUPPORTIVE CARE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.