Healthcare Provider Details

I. General information

NPI: 1598697005
Provider Name (Legal Business Name): GREENTECHCONCEPT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 PINE CREEK CT
WATERFORD MI
48327-1586
US

IV. Provider business mailing address

400 MARYLAND AVE SW
WASHINGTON DC
20202-0001
US

V. Phone/Fax

Practice location:
  • Phone: 248-241-1522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH L HUTCHENS
Title or Position: INTERN
Credential: BS/ENG
Phone: 248-241-1522