Green Haven Adult Day Program LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

GREEN HAVEN ADULT DAY PROGRAM LLC

Practice address

6207 N Lindbergh Blvd
Hazelwood, MO 63042-2817

Phone

(314) 393-1639

NPI assigned

Aug 12, 2021

Last updated

Aug 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Tiffany Danielle GreenNPI 1912573510

Title

Program Director

Phone

(314) 393-1639

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tiffany Danielle Green

  • Nursing Home Administrator
  • Hazelwood, MO
  • NPI 1912573510
  NPD Authorized official

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1770258568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 TIMBERWOOD CROSSING CT",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630317518",
            "telephone_number": "314-393-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6207 N LINDBERGH BLVD",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630422817",
            "telephone_number": "314-393-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN HAVEN ADULT DAY PROGRAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "314-393-1639",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Fleming Glenn, CCP
• Lillie M Glenn, LPC
• Golden Heart Adult Day Program, LLC
• Golden Touch ABA Mo, LLC
• Darlene Gollaher
• Green Way Transportation LLC
• Tiffany Danielle Green
• Halyssa Greene, LPC
• Ashley Greer
• Nicole Griffin, PLPC

• Adult Care Home Facility in Hazelwood, MO
• Providers in Hazelwood, MO by specialty
• Adult Care Home Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.