Greenbriar Prime Management

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

125703 Issued in TX

Legal business name

GREENBRIAR PRIME MANAGEMENT

Doing business as

Heritage Square

Practice address

500 S Beach St
Fort Worth, TX 76105-1104

Phone

(817) 535-3827

Fax

(817) 535-1362

NPI assigned

Jan 15, 2009

Last updated

Jan 15, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

WGH-HERITAGE, INCAs reported in NPPES

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

Authorized official

Name

Mr. Doug Sweeney

Title

President

Phone

(817) 535-3827

Specialties & licenses 1

Addresses

Other names 1

• Heritage Square Doing business as

Tax ID family

Greenbriar Mansion2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Greenbriar Prime Management, LLC.

  dba Greenbriar Mansion

  • Assisted Living Facility
  • Fort Worth, TX
  • NPI 1942447750
  NPD tax ID

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231977600000",
    "number": "1487891297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2260",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761132260",
            "telephone_number": "817-535-3827",
            "fax_number": "817-535-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S BEACH ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761051104",
            "telephone_number": "817-535-3827",
            "fax_number": "817-535-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBRIAR PRIME MANAGEMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WGH-HERITAGE, INC",
        "enumeration_date": "2009-01-15",
        "last_updated": "2009-01-15",
        "status": "A",
        "authorized_official_last_name": "SWEENEY",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-535-3827",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "125703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Square",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thom L Green, RPH
• Tiffany Green, M.ED, NCC, LPC
• Tina J Green, SLP
• Mylie Greenbach, MS, LPC, RPT, NCC
• Greenbelt Anesthesia Assoc Inc
• Greenbriar Prime Management, LLC. (Greenbriar Mansion)
• Christina Greene, DDS
• Douglas E Greene, MD
• Julie Beth Greene, D.O.
• Monica Rose Greene, P.T.

• Assisted Living Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; 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.