Provider Demographics
NPI:1780289298
Name:GREEN THERAPY, LLC
Entity type:Organization
Organization Name:GREEN THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:STROMBOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-606-5234
Mailing Address - Street 1:PO BOX 231492
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70183-1492
Mailing Address - Country:US
Mailing Address - Phone:504-533-8846
Mailing Address - Fax:888-328-5302
Practice Address - Street 1:10105 HYDE PL
Practice Address - Street 2:
Practice Address - City:RIVER RIDGE
Practice Address - State:LA
Practice Address - Zip Code:70123-1523
Practice Address - Country:US
Practice Address - Phone:504-606-5234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies