Provider Demographics
NPI:1538862842
Name:GREEN LIGHT
Entity type:Organization
Organization Name:GREEN LIGHT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:OPUTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-691-5725
Mailing Address - Street 1:12714 RACHELS WAY
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-8004
Mailing Address - Country:US
Mailing Address - Phone:281-691-5725
Mailing Address - Fax:
Practice Address - Street 1:12714 RACHELS WAY
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-8004
Practice Address - Country:US
Practice Address - Phone:281-691-5725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies