MEDICARE: THE FORT GREENE PROJECT 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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1871459115
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE FORT GREENE PROJECT INC

Provider Business Mailing Address
First Line	:	3836 S 54TH GLN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043-4762
Country	:	US
Telephone Number	:	602-430-8861
Fax Number	:

Provider Business Practice Location Address
First Line	:	3836 S 54TH GLN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043-4762
Country	:	US
Telephone Number	:	602-430-8861
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. TIMEKE LAMAR MITCHELL-WALKER
Credential	:
Telephone Number	:	602-430-8861

Provider Enumeration Date	:	12/30/2025
Last Update Date	:	01/08/2026

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Directions to “THE FORT GREENE PROJECT INC ” Practice Location

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