Healthcare Provider Details

I. General information

NPI: 1467194118
Provider Name (Legal Business Name): GREENWISE SENIOR SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3471 VILLAGE PARK LN SW
ATLANTA GA
30331-7951
US

IV. Provider business mailing address

235 PEACHTREE ST NE STE 431
ATLANTA GA
30303-1401
US

V. Phone/Fax

Practice location:
  • Phone: 470-343-9644
  • Fax: 470-594-4313
Mailing address:
  • Phone: 678-999-1206
  • Fax: 470-594-4313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ERIC HELVY
Title or Position: FOUNDER
Credential:
Phone: 678-999-1206