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NPI Code Detail

MEDICARE: GREEN APPLE HEALTH SERVICES LLC

MEDICARE: GREEN APPLE HEALTH SERVICES LLC
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
1343900000XNon-emergency Medical Transport (VAN)
2101YP2500XProfessional Counselor
3251B00000XCase Management Agency
4261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1487315586
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREEN APPLE HEALTH SERVICES LLC
Provider Business Mailing Address
First Line : 4717 E MCDOWELL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4544
Country : US
Telephone Number : 602-282-4830
Fax Number : 602-807-6758
Provider Business Practice Location Address
First Line : 4717 E MCDOWELL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4544
Country : US
Telephone Number : 252-266-1478
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. TAKESHA SHEARD
Credential : MBA
Telephone Number : 602-282-4830
Provider Enumeration Date : 01/02/2022
Last Update Date : 04/05/2022

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