Provider Demographics
NPI:1285107482
Name:GREENBRIAR CHILDREN'S CENTER INC
Entity type:Organization
Organization Name:GREENBRIAR CHILDREN'S CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GENA
Authorized Official - Middle Name:P
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-234-3431
Mailing Address - Street 1:3709 HOPKINS ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-3028
Mailing Address - Country:US
Mailing Address - Phone:912-234-3431
Mailing Address - Fax:912-238-9149
Practice Address - Street 1:3709 HOPKINS ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-3028
Practice Address - Country:US
Practice Address - Phone:912-234-3431
Practice Address - Fax:912-238-9149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAA704354OtherGA SECRETARY OF STATE CONTROL NUMBER