MEDICARE: GREEN SPRINGS WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor
3	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1134970023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREEN SPRINGS WELLNESS

Provider Business Mailing Address
First Line	:	1600 WESTGATE CIR STE 255
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-8553
Country	:	US
Telephone Number	:	629-401-8486
Fax Number	:	732-503-8962

Provider Business Practice Location Address
First Line	:	390 AMWELL RD STE 504
Second Line	:
City	:	HILLSBOROUGH
State	:	NJ
Zip	:	08844-1248
Country	:	US
Telephone Number	:	629-401-8486
Fax Number	:	732-503-8962

Authorized Official
Title or Position	:	CRO
Name	:	JAKE SMITH
Credential	:
Telephone Number	:	629-401-8486

Provider Enumeration Date	:	03/28/2024
Last Update Date	:	05/19/2026

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Directions to “GREEN SPRINGS WELLNESS ” Practice Location

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