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NPI Code Detail

MEDICARE: THE GREEN HOME

MEDICARE: THE GREEN HOME
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
1314000000XSkilled Nursing Facility072202PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699772327
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE GREEN HOME
Provider Business Mailing Address
First Line : 37 CENTRAL AVE
Second Line :
City : WELLSBORO
State : PA
Zip : 16901-1857
Country : US
Telephone Number : 570-724-3131
Fax Number : 570-724-2367
Provider Business Practice Location Address
First Line : 37 CENTRAL AVE
Second Line :
City : WELLSBORO
State : PA
Zip : 16901-1857
Country : US
Telephone Number : 570-724-3131
Fax Number : 570-724-2367
Authorized Official
Title or Position : CFO
Name : ROGER C. YOST
Credential :
Telephone Number : 570-321-3175
Provider Enumeration Date : 07/07/2005
Last Update Date : 02/05/2025

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1396149589 — MRS. JENNIFER ALDINGER COTA/L
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1750771713 — LORRAINE KRISTEL ALEXANDER
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Directions to “THE GREEN HOME ” 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.

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