Provider Demographics
NPI:1790078996
Name:GREEN CARE HOMES OF TENNESSEE, LLC
Entity type:Organization
Organization Name:GREEN CARE HOMES OF TENNESSEE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:615-649-8288
Mailing Address - Street 1:107 MUSIC CITY CIRCLE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214
Mailing Address - Country:US
Mailing Address - Phone:615-649-8288
Mailing Address - Fax:615-964-7730
Practice Address - Street 1:107 MUSIC CITY CIRCLE
Practice Address - Street 2:SUITE 116
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214
Practice Address - Country:US
Practice Address - Phone:615-649-8288
Practice Address - Fax:615-964-7730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-20
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 253Z00000X
TN1000000015615251S00000X
TN1000000020969251S00000X
TN1000000020986251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health