Provider Demographics
NPI:1154773042
Name:GREENE BEHAVIORAL HEALTH, INC.
Entity type:Organization
Organization Name:GREENE BEHAVIORAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GREEN
Authorized Official - Last Name:GAITHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-759-5496
Mailing Address - Street 1:701 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3361
Mailing Address - Country:US
Mailing Address - Phone:832-759-5496
Mailing Address - Fax:832-847-4433
Practice Address - Street 1:701 S 11TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3361
Practice Address - Country:US
Practice Address - Phone:832-759-5496
Practice Address - Fax:832-847-4433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2016-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62893104100000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty