Green Merrylands Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GREEN MERRYLANDS INC

Practice address

15986 Baltray Way
Fontana, CA 92336-4546

Phone

(909) 854-3227

NPI assigned

Jul 29, 2019

Organization subpart

No

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

Authorized official

Name

NA Zhao

Title

Cfo

Phone

(818) 267-0352

Specialties & licenses 3

Addresses

Other names 1

• Green Merrylands Inc. Former legal business name

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564358400000",
    "number": "1952955841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N HAVEN AVE STE 210",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644951",
            "telephone_number": "909-476-0115",
            "fax_number": "909-360-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15986 BALTRAY WAY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364546",
            "telephone_number": "909-854-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN MERRYLANDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-07-29",
        "status": "A",
        "authorized_official_last_name": "ZHAO",
        "authorized_official_first_name": "NA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "818-267-0352"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Merrylands Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• George Miller Grames, M.D.
• Karin Irene Granberg, M.P.T., D.SC.
• Alicia Christina Gray, MS
• Summer Margaret Gray
• Great I Am Welfare and Development Home Health Agency LLC
• Dominnique Green
• Henrietta Anne Green, PA-C
• Damon Lamont Greene, M.D.
• Tambra Greene, LCSW
• Divine Kaur Grewal, PHARMD

• Assisted Living Facility in Fontana, CA
• Providers in Fontana, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; 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.