Provider Demographics
NPI:1366032880
Name:GREENVILLE TRANSITIONS RECOVERY CENTER, LLC
Entity Type:Organization
Organization Name:GREENVILLE TRANSITIONS RECOVERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HARRISON
Authorized Official - Last Name:MCNEASE
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:828-620-3425
Mailing Address - Street 1:25 SWEETBRIAR RD STE 4A
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-1459
Mailing Address - Country:US
Mailing Address - Phone:864-404-6534
Mailing Address - Fax:
Practice Address - Street 1:25 SWEETBRIAR RD STE 4A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-1459
Practice Address - Country:US
Practice Address - Phone:864-404-6534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility