Provider Demographics
NPI:1437644762
Name:TREBBLE HEALTH CARE SERVICES INC.
Entity Type:Organization
Organization Name:TREBBLE HEALTH CARE SERVICES INC.
Other - Org Name:CROSSROADS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BILY
Authorized Official - Middle Name:E
Authorized Official - Last Name:GREENING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-876-0826
Mailing Address - Street 1:158 BRIDGE STREET
Mailing Address - Street 2:
Mailing Address - City:SENOIA
Mailing Address - State:GA
Mailing Address - Zip Code:30276
Mailing Address - Country:US
Mailing Address - Phone:770-876-0826
Mailing Address - Fax:678-809-2923
Practice Address - Street 1:2511 HIGHWAY 34 E
Practice Address - Street 2:SUITE B
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265
Practice Address - Country:US
Practice Address - Phone:770-573-0167
Practice Address - Fax:678-809-2923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA42585207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty