Provider Demographics
NPI:1851156426
Name:GREENFIELDS PROGRAM SERVICES
Entity Type:Organization
Organization Name:GREENFIELDS PROGRAM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMANI-NWEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-401-8910
Mailing Address - Street 1:637 E ALBERTONI ST STE 109
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1543
Mailing Address - Country:US
Mailing Address - Phone:310-532-0063
Mailing Address - Fax:
Practice Address - Street 1:637 E ALBERTONI ST STE 109
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-1543
Practice Address - Country:US
Practice Address - Phone:310-532-0063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child