MEDICARE: GREATER HE 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	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number	:	1790628733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER HE LLC

Provider Business Mailing Address
First Line	:	10600 HAMLIN DR
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-1186
Country	:	US
Telephone Number	:	804-318-1062
Fax Number	:

Provider Business Practice Location Address
First Line	:	10600 HAMLIN DR
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-1186
Country	:	US
Telephone Number	:	804-318-1062
Fax Number	:

Authorized Official
Title or Position	:	CO OWNER
Name	:	JONATHAN OVERTON
Credential	:
Telephone Number	:	757-633-2016

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “GREATER HE LLC ” Practice Location

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