Provider Demographics
NPI:1538329529
Name:GREEN HILLS COMMUNITY ACTION AGENCY
Entity Type:Organization
Organization Name:GREEN HILLS COMMUNITY ACTION AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WOMEN'S HEALTH PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:DEAN-BATSON
Authorized Official - Suffix:
Authorized Official - Credentials:WHNP BC
Authorized Official - Phone:660-359-2855
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:1506 OKLAHOMA AVENUE
Mailing Address - City:TRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:64683-2587
Mailing Address - Country:US
Mailing Address - Phone:660-359-2855
Mailing Address - Fax:660-359-6619
Practice Address - Street 1:1506 OKLAHOMA AVENUE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MO
Practice Address - Zip Code:64683-2587
Practice Address - Country:US
Practice Address - Phone:660-359-2855
Practice Address - Fax:660-359-6619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility