Provider Demographics
NPI:1467203612
Name:GREENVILLE OPERATOR LLC
Entity Type:Organization
Organization Name:GREENVILLE OPERATOR LLC
Other - Org Name:GREENVILLE NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:NEISWANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-758-7100
Mailing Address - Street 1:2578 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7812
Mailing Address - Country:US
Mailing Address - Phone:252-758-7100
Mailing Address - Fax:
Practice Address - Street 1:2578 W 5TH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7812
Practice Address - Country:US
Practice Address - Phone:252-758-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility