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General NPI Number Information
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NPI Number | 1851517437
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Entity Type | Organization
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Legal Business Name | GREEN HILLS SUPERIOR CARE, INC.
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 915 E 9TH ST
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City | TRENTON
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State | MO
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Zip | 64683-0216
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Country | US
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Telephone | 660-359-6777
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Fax | 330-359-3113
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Provider Business Mailing Address
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Address Line | 915 E 9TH ST PO BOX 216
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City | TRENTON
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State | MO
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Zip | 64683-0216
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Country | US
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Telephone | 660-359-6777
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Fax | 330-359-3113
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SUSAN G BARNES
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Credential |
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Telephone | 660-359-6777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 7053908
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License Number State | MO
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