Provider Demographics
NPI:1235663790
Name:GREEN HILL RECOVERY, LLC
Entity Type:Organization
Organization Name:GREEN HILL RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:EULAN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:828-228-6148
Mailing Address - Street 1:6112 SAINT GILES ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-7043
Mailing Address - Country:US
Mailing Address - Phone:984-204-8076
Mailing Address - Fax:984-204-8076
Practice Address - Street 1:6112 SAINT GILES ST STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-7043
Practice Address - Country:US
Practice Address - Phone:984-204-1106
Practice Address - Fax:984-204-8076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder