Provider Demographics
NPI:1740587484
Name:GREENFIELDS HEALTH SERVICES INC
Entity Type:Organization
Organization Name:GREENFIELDS HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:CHIKE
Authorized Official - Last Name:NWEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-532-0063
Mailing Address - Street 1:637 E ALBERTONI ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1539
Mailing Address - Country:US
Mailing Address - Phone:310-532-0063
Mailing Address - Fax:310-626-9754
Practice Address - Street 1:612 W E ST
Practice Address - Street 2:WILMINGTON TEEN CENTER
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-5510
Practice Address - Country:US
Practice Address - Phone:424-204-2703
Practice Address - Fax:310-626-9754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190600AP251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health