MEDICARE: GREENE HORIZONS

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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1588260723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENE HORIZONS

Provider Business Mailing Address
First Line	:	7 ELY PL
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-3005
Country	:	US
Telephone Number	:	917-936-6288
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 BARLOW RD
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-3022
Country	:	US
Telephone Number	:	732-535-7343
Fax Number	:	732-503-8962

Authorized Official
Title or Position	:	MANAGER
Name	:	DAVID GREENE
Credential	:	LCSW
Telephone Number	:	917-936-6288

Provider Enumeration Date	:	12/10/2020
Last Update Date	:	01/20/2022

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Directions to “GREENE HORIZONS ” Practice Location

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