Provider Demographics
NPI:1093885220
Name:GREENSPRING VILLAGE, INC.
Entity Type:Organization
Organization Name:GREENSPRING VILLAGE, INC.
Other - Org Name:GREENSPRING HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-402-2315
Mailing Address - Street 1:7440 SPRING VILLAGE DRIVE
Mailing Address - Street 2:ATTN: EXECUTIVE DIRECTOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-4446
Mailing Address - Country:US
Mailing Address - Phone:703-923-4600
Mailing Address - Fax:410-204-7237
Practice Address - Street 1:7400 SPRING VILLAGE DR
Practice Address - Street 2:ATTN: HOSPICE ADMINISTRATOR
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-4480
Practice Address - Country:US
Practice Address - Phone:703-923-4600
Practice Address - Fax:410-204-7237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHSP-15142251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA491591Medicare Oscar/Certification