MEDICARE: GREENFIELD CARE LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1457866030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENFIELD CARE LLC

Provider Business Mailing Address
First Line	:	10518 KIPP WAY DR STE B-1
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77099-2400
Country	:	US
Telephone Number	:	832-288-4928
Fax Number	:	832-288-4844

Provider Business Practice Location Address
First Line	:	10518 KIPP WAY DR STE B-1
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77099-2400
Country	:	US
Telephone Number	:	832-288-4928
Fax Number	:	832-288-4844

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOYCE CLOVER
Credential	:
Telephone Number	:	832-288-4928

Provider Enumeration Date	:	12/05/2017
Last Update Date	:	12/05/2017

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