MEDICARE: GREENSPRING VILLAGE, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1346240389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENSPRING VILLAGE, INC.

Provider Business Mailing Address
First Line	:	7440 SPRING VILLAGE DRIVE
Second Line	:	ATTN: EXECUTIVE DIRECTOR
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-4446
Country	:	US
Telephone Number	:	703-923-4600
Fax Number	:	410-204-7237

Provider Business Practice Location Address
First Line	:	7400 SPRING VILLAGE DRIVE
Second Line	:	ATTN: HOME HEALTH ADMINISTRATOR
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-4480
Country	:	US
Telephone Number	:	703-923-4600
Fax Number	:	410-204-7237

Authorized Official
Title or Position	:	FINANCE DIRECTOR
Name	:	JAMES K WALTER
Credential	:
Telephone Number	:	410-402-2315

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	01/16/2015

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