Provider Demographics
NPI:1649663204
Name:PAMELA GREEN CHILDREN'S HOUSE
Entity type:Organization
Organization Name:PAMELA GREEN CHILDREN'S HOUSE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:HILLKIRK
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-440-4237
Mailing Address - Street 1:46 E DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:PA
Mailing Address - Zip Code:16428-1350
Mailing Address - Country:US
Mailing Address - Phone:814-440-4237
Mailing Address - Fax:
Practice Address - Street 1:46 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:NORTH EAST
Practice Address - State:PA
Practice Address - Zip Code:16428-1350
Practice Address - Country:US
Practice Address - Phone:814-440-4237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty