Provider Demographics
NPI:1639900392
Name:GREEN HILLS PLAYHOUSE THERAPY
Entity type:Organization
Organization Name:GREEN HILLS PLAYHOUSE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ALISE
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:601-540-7852
Mailing Address - Street 1:1303 LONE OAK CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-3905
Mailing Address - Country:US
Mailing Address - Phone:601-540-7852
Mailing Address - Fax:
Practice Address - Street 1:1303 LONE OAK CIR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3905
Practice Address - Country:US
Practice Address - Phone:601-540-7852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1790181394OtherSPEECH LANGUAGE PATHOLOGIST
TN1073236436OtherSPEECH LANGUAGE PATHOLOGIST