Provider Demographics
NPI:1720269087
Name:GREENWOODS, INC.
Entity Type:Organization
Organization Name:GREENWOODS, INC.
Other - Org Name:FRIENDSHIP CARE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:AVERY
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-686-3553
Mailing Address - Street 1:PO BOX 29108
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27429-9108
Mailing Address - Country:US
Mailing Address - Phone:336-686-3553
Mailing Address - Fax:336-643-9776
Practice Address - Street 1:4501 OLD BATTLEGROUND RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-9352
Practice Address - Country:US
Practice Address - Phone:336-282-2253
Practice Address - Fax:336-282-1308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-041-002310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7802930Medicaid