Provider Demographics
NPI:1619360997
Name:GREENE CARE LLC
Entity type:Organization
Organization Name:GREENE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-998-4296
Mailing Address - Street 1:74 FOCH CIRCLE #331
Mailing Address - Street 2:
Mailing Address - City:NEMACOLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15351-0331
Mailing Address - Country:US
Mailing Address - Phone:724-998-5683
Mailing Address - Fax:724-966-7955
Practice Address - Street 1:74 FOCH CIRCLE #331
Practice Address - Street 2:
Practice Address - City:NEMACOLIN
Practice Address - State:PA
Practice Address - Zip Code:15351-0331
Practice Address - Country:US
Practice Address - Phone:724-998-5683
Practice Address - Fax:724-966-7955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA27403601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care