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General NPI Number Information
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NPI Number | 1174159057
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Entity Type | Organization
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Legal Business Name | GREEN HILL RECOVERY, LLC
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 07/28/2021
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Provider Practice Location Address
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Address Line | 6112 SAINT GILES ST
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City | RALEIGH
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State | NC
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Zip | 27612-7043
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Country | US
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Telephone | 828-228-6148
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Fax | 984-204-8076
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Provider Business Mailing Address
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Address Line | 6112 SAINT GILES ST
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City | RALEIGH
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State | NC
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Zip | 27612-7043
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Country | US
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Telephone | 984-204-8076
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Fax | 984-204-8076
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Authorized Official
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Title or Position | CEO
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Name | J. EULAN JOHNSON
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Credential |
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Telephone | 828-228-6148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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