MEDICARE: GREEN TREE HOME HEALTH 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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1649163775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREEN TREE HOME HEALTH LLC.

Provider Business Mailing Address
First Line	:	1600 S DIXIE HWY STE G
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-5890
Country	:	US
Telephone Number	:	561-502-2274
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 S DIXIE HWY STE G
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-5890
Country	:	US
Telephone Number	:	561-502-2274
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ONINE POLIDORT
Credential	:
Telephone Number	:	561-502-2274

Provider Enumeration Date	:	05/29/2025
Last Update Date	:	05/29/2025

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