Provider Demographics
NPI:1932529724
Name:GREENE AID OPCO LLC
Entity Type:Organization
Organization Name:GREENE AID OPCO LLC
Other - Org Name:GREENE PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-725-7000
Mailing Address - Street 1:330 N WABASH AVE
Mailing Address - Street 2:SUITE 3700
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3586
Mailing Address - Country:US
Mailing Address - Phone:312-725-7000
Mailing Address - Fax:312-332-5902
Practice Address - Street 1:600 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434-6015
Practice Address - Country:US
Practice Address - Phone:888-836-3466
Practice Address - Fax:312-332-5497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEALF074310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility