Provider Demographics
NPI:1548795628
Name:GREENE OAKS OPERATING LLC
Entity Type:Organization
Organization Name:GREENE OAKS OPERATING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-731-1700
Mailing Address - Street 1:180 SYLVAN AV 2ND FLOOR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632
Mailing Address - Country:US
Mailing Address - Phone:201-731-1700
Mailing Address - Fax:
Practice Address - Street 1:180 SYLVAN AV 2ND FLOOR
Practice Address - Street 2:SUITE 4
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632
Practice Address - Country:US
Practice Address - Phone:201-731-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1775N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH365601Medicare Oscar/Certification