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General NPI Number Information
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NPI Number | 1528636636
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Entity Type | Organization
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Legal Business Name | GREEN HEALTH LLC
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1205 N POLLOCK ST LOT 9
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City | SELMA
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State | NC
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Zip | 27576-5618
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Country | US
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Telephone | 804-718-5440
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 N POLLOCK ST LOT 9
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City | SELMA
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State | NC
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Zip | 27576-5618
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Country | US
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Telephone | 804-718-5440
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHADDRICK CHAPPELL
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Credential |
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Telephone | 804-718-5440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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