Provider Demographics
NPI:1932551744
Name:GREENE BEHAVIORAL HEALTH, INC.
Entity Type:Organization
Organization Name:GREENE BEHAVIORAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GREEN
Authorized Official - Last Name:GAITHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-759-5496
Mailing Address - Street 1:16860 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MC KENZIE
Mailing Address - State:TN
Mailing Address - Zip Code:38201-1620
Mailing Address - Country:US
Mailing Address - Phone:731-393-0450
Mailing Address - Fax:731-393-0451
Practice Address - Street 1:16860 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:MC KENZIE
Practice Address - State:TN
Practice Address - Zip Code:38201-1620
Practice Address - Country:US
Practice Address - Phone:731-393-0450
Practice Address - Fax:731-393-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health