Provider Demographics
NPI:1417673013
Name:GREENWOOD HEALTHARE
Entity Type:Organization
Organization Name:GREENWOOD HEALTHARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:216-355-2359
Mailing Address - Street 1:4833 LINDSEY OVAL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2931
Mailing Address - Country:US
Mailing Address - Phone:216-355-2359
Mailing Address - Fax:
Practice Address - Street 1:4833 LINDSEY OVAL
Practice Address - Street 2:
Practice Address - City:RICHMOND HTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2931
Practice Address - Country:US
Practice Address - Phone:216-355-2359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services