MEDICARE: GREYSTONE BEHAVIORAL HEALTH NURSING 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1346849213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREYSTONE BEHAVIORAL HEALTH NURSING INC

Provider Business Mailing Address
First Line	:	231 E ALESSANDRO BLVD STE A438
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92508-5084
Country	:	US
Telephone Number	:	951-732-8715
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 E ALESSANDRO BLVD STE A438
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92508-5084
Country	:	US
Telephone Number	:	951-732-8715
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RAINAT AJOKE SALAAM
Credential	:	NP
Telephone Number	:	310-493-1498

Provider Enumeration Date	:	10/22/2020
Last Update Date	:	10/22/2020

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