| NPI | 1215604822 |
|---|---|
| Doing Business As | GREENE HAVEN FAMILY CARE HOME |
| Entity Type | Organization |
| Authorized Contact | BERNICE R HOSCH Administrator/Operator 980-295-3020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2021-09-15 |