Greene Pak Psychiatric Service Inc

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

GREENE PAK PSYCHIATRIC SERVICE INC

Practice address

482 N Detroit St
Xenia, OH 45385

Phone

(937) 374-6010

Fax

(937) 374-6014

NPI assigned

Dec 8, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mahmood Rahman, MD

Title

Owner

Phone

(937) 374-6010

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Albert Dachowski Jr., MD

  • Psychiatry Physician
  • Gallipolis, OH
  • NPI 1962478404
  NPD (past)
• Phyllis J Lackey, LIC PROF COUNSELOR

  • Counselor
  • Xenia, OH
  • NPI 1174682504
  NPD (past)
• Sandya I. Gunasekera, MD

  • Psychiatry Physician
  • Muncie, IN
  • NPI 1164473492
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1124187554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 FORDWAY DR",
            "address_2": "STE 2",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "45377",
            "telephone_number": "937-890-3139",
            "fax_number": "937-890-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 N DETROIT ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "45385",
            "telephone_number": "937-374-6010",
            "fax_number": "937-374-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE PAK PSYCHIATRIC SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "RAHMAN",
        "authorized_official_first_name": "MAHMOOD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-374-6010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0976949",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greene Memorial Hospital Services, Inc
• Greene Memorial Hospital Services, Inc.
• Greene Memorial Hospital Services, Inc.
• Greene Memorial Hospital, Inc.
• Greene Oaks
• Greene, Inc.
• Nicole Greene
• Ronald J Greene, DDS
• Danielle Greenside, STNA
• Greenville Nursing Services Inc.

• Adult Mental Health Clinic/Center in Xenia, OH
• Providers in Xenia, OH by specialty
• Adult Mental Health Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.