Provider Demographics
NPI:1700658820
Name:GREEN CARE HOMES OF ALABAMA, LLC.
Entity type:Organization
Organization Name:GREEN CARE HOMES OF ALABAMA, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:615-667-1155
Mailing Address - Street 1:12973 JUNIORS DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-2842
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:615-380-8020
Practice Address - Street 1:12973 JUNIORS DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35756-2842
Practice Address - Country:US
Practice Address - Phone:615-667-1155
Practice Address - Fax:615-380-8020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health