Provider Demographics
NPI:1164063822
Name:GREENHEART TOWER INC
Entity Type:Organization
Organization Name:GREENHEART TOWER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:B
Authorized Official - Last Name:LE- MOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-932-2312
Mailing Address - Street 1:555 CHRISTOPHER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-7029
Mailing Address - Country:US
Mailing Address - Phone:347-932-2312
Mailing Address - Fax:
Practice Address - Street 1:555 CHRISTOPHER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-7029
Practice Address - Country:US
Practice Address - Phone:347-932-2312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty