Gary Green

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

230000294 Issued in CA

Legal business name

GARY GREEN

Practice address

1494 Arch Way
Chico, CA 95973

Phone

(530) 226-0375

Fax

(530) 365-1609

NPI assigned

Feb 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gary M Green

Title

Licensee/Owner

Phone

(530) 226-0375

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nova Development Centers (Arch Way House) Doing business as

Tax ID family

Gary Green3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Gary Green

  • Intellectual Disabilities Intermediate Care Facility
  • Chico, CA
  • NPI 1134193600
  NPD tax ID
• Gary Green

  • Intellectual Disabilities Intermediate Care Facility
  • Chico, CA
  • NPI 1316911886
  NPD tax ID

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1225002793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 492478",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "96049",
            "telephone_number": "530-226-0375",
            "fax_number": "530-365-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1494 ARCH WAY",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "95973",
            "telephone_number": "530-226-0375",
            "fax_number": "530-365-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY GREEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LICENSEE/OWNER",
        "authorized_official_telephone_number": "530-226-0375",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "230000294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC80241F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nova Development Centers (Arch Way House)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karolyn Kay Garrett, RN
• Bryan Davis Garrettson I
• Heather Lynn Garrido, PA-C
• Mark S Garrison, DO
• Gary Green
• Gary Green
• Gary Incaudo M D Inc
• Nicholas Gaskill, MD
• Jeneice Capri Gaston
• Holly Lynne Gatti, SLP-CCC

• Intellectual Disabilities Intermediate Care Facility in Chico, CA
• Providers in Chico, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.