Greene Wellness and Rehab Center LLC.

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

692 Issued in MA

Legal business name

GREENE WELLNESS AND REHAB CENTER LLC.

Practice address

708 Broadway
Revere, MA 02151-2334

Phone

(781) 284-4001

Fax

(781) 284-4116

NPI assigned

Aug 15, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Richie Hernandez

Title

Manager

Phone

(781) 284-4001

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471219200000",
    "number": "1982158374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 BROADWAY",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021512334",
            "telephone_number": "781-284-4001",
            "fax_number": "781-284-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 BROADWAY",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021512334",
            "telephone_number": "781-284-4001",
            "fax_number": "781-284-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE WELLNESS AND REHAB CENTER LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-15",
        "last_updated": "2016-08-15",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "RICHIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "781-284-4001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MA",
            "license": "692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Gottfried, M.D.
• Antonio Granfone, MD
• Joan Granitsas, CRNP
• Polly Walker Grant
• Richard William Grant, MD MPH
• Cheryl Ann Griffin, RN
• Crystal Grimes, NP
• Kenia Guerrero
• Theresa Cary Guillaume, LICSW
• Erica Guingue

• Exclusive Provider Organization in Revere, MA
• Providers in Revere, MA by specialty
• Exclusive Provider Organization in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.