Provider Demographics
NPI:1003643578
Name:GREENING HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:GREENING HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:EGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-347-1747
Mailing Address - Street 1:2800 E ENTERPRISE AVE STE 333
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-7889
Mailing Address - Country:US
Mailing Address - Phone:763-485-1011
Mailing Address - Fax:
Practice Address - Street 1:2800 E ENTERPRISE AVE STE 333
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7889
Practice Address - Country:US
Practice Address - Phone:763-485-1011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)