Provider Demographics
NPI:1902801632
Name:GREENBROOK NH, LLC
Entity Type:Organization
Organization Name:GREENBROOK NH, LLC
Other - Org Name:APOLLO HEALTH AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-557-6200
Mailing Address - Street 1:1000 24TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-6838
Mailing Address - Country:US
Mailing Address - Phone:727-323-4711
Mailing Address - Fax:727-321-5963
Practice Address - Street 1:1000 24TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-6838
Practice Address - Country:US
Practice Address - Phone:727-323-4711
Practice Address - Fax:727-321-5963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF11830962314000000X
332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0227633-00Medicaid
FL105202Medicare Oscar/Certification
FL5586780001Medicare NSC