Provider Demographics
NPI:1023325834
Name:T. GREENE MANAGEMENT COMPANY, LLC
Entity type:Organization
Organization Name:T. GREENE MANAGEMENT COMPANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:WASHINGTON
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:MED LPC
Authorized Official - Phone:405-657-9236
Mailing Address - Street 1:109 S LEXINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-4221
Mailing Address - Country:US
Mailing Address - Phone:405-513-6901
Mailing Address - Fax:405-285-9074
Practice Address - Street 1:109 S LEXINGTON WAY
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-4221
Practice Address - Country:US
Practice Address - Phone:405-513-6901
Practice Address - Fax:405-285-9074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3311251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health