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General NPI Number Information
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NPI Number | 1972356376
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Entity Type | Organization
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Legal Business Name | GREENEWELL LLC
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 2332 GALIANO ST FL 2
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City | CORAL GABLES
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State | FL
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Zip | 33134-5402
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Country | US
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Telephone | 786-268-6706
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Fax |
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Provider Business Mailing Address
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Address Line | 2332 GALIANO ST FL 2
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City | CORAL GABLES
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State | FL
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Zip | 33134-5402
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Country | US
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Telephone | 786-268-6706
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Fax |
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Authorized Official
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Title or Position | OWNER ADMINISTRATOR
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Name | RICHARD GREENE
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Credential |
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Telephone | 786-268-6706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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