Provider Demographics
NPI:1376998765
Name:GREENLIFE HOMECARE LLC
Entity Type:Organization
Organization Name:GREENLIFE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TIWARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-302-7833
Mailing Address - Street 1:87 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01118-1329
Mailing Address - Country:US
Mailing Address - Phone:412-302-7833
Mailing Address - Fax:
Practice Address - Street 1:87 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01118-1329
Practice Address - Country:US
Practice Address - Phone:412-302-7833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health