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General NPI Number Information
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NPI Number | 1720269087
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Entity Type | Organization
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Legal Business Name | GREENWOODS, INC.
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 4501 OLD BATTLEGROUND RD
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City | GREENSBORO
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State | NC
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Zip | 27410-9352
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Country | US
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Telephone | 336-282-2253
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Fax | 336-282-1308
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Provider Business Mailing Address
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Address Line | PO BOX 29108
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City | GREENSBORO
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State | NC
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Zip | 27429-9108
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Country | US
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Telephone | 336-686-3553
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Fax | 336-643-9776
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. AVERY BRADLEY GREEN
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Credential |
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Telephone | 336-686-3553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | HAL-041-002
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License Number State | NC
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