Greengate Intensive, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

BH-3440 Issued in AZ

Legal business name

GREENGATE INTENSIVE, LLC

Practice address

1560 E Route 66
Flagstaff, AZ 86001-4821

Phone

(928) 814-2008

NPI assigned

Mar 22, 2010

Organization subpart

No

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

Authorized official

Name

John Diguiseppe

Title

Director

Phone

(818) 429-2188

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269216000000",
    "number": "1619291549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E ROUTE 66",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014821",
            "telephone_number": "928-814-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 E ROUTE 66",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014821",
            "telephone_number": "928-814-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENGATE INTENSIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-22",
        "last_updated": "2010-03-22",
        "status": "A",
        "authorized_official_last_name": "DIGUISEPPE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "818-429-2188"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AZ",
            "license": "BH-3440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Gerard Green, DDS
• Zachary Tyler Green, OD
• James S Greenan, RPH
• Mark J Greene, D.M.D.
• Michael Cayman Greene, ATC
• David Greenwalt
• Andrew J Gregg, D.C.
• Wesley Gregg, D.C.
• Gregory a. Cox, PA-C, PLLC
• Gregory D. Novak, M.D. P.C.

• Substance Abuse Rehabilitation Facility in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; 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.