MEDICARE: GREEN HILL AT HOME

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1871954321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREEN HILL AT HOME

Provider Business Mailing Address
First Line	:	103 PLEASANT VALLEY WAY
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-2905
Country	:	US
Telephone Number	:	973-731-2300
Fax Number	:	973-731-5185

Provider Business Practice Location Address
First Line	:	103 PLEASANT VALLEY WAY
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-2905
Country	:	US
Telephone Number	:	973-731-2300
Fax Number	:	973-731-5185

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TONI LYNN M DAVIS
Credential	:	MHA, CNHA
Telephone Number	:	973-731-2300

Provider Enumeration Date	:	03/11/2016
Last Update Date	:	03/11/2016

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Directions to “GREEN HILL AT HOME ” Practice Location

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