Provider Demographics
NPI:1306170576
Name:GREEN APPLE LLC
Entity type:Organization
Organization Name:GREEN APPLE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRANTHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-533-2886
Mailing Address - Street 1:1431 GREENWAY DRIVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038
Mailing Address - Country:US
Mailing Address - Phone:214-467-9787
Mailing Address - Fax:469-949-9888
Practice Address - Street 1:1431 GREENWAY DRIVE
Practice Address - Street 2:SUITE 500
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038
Practice Address - Country:US
Practice Address - Phone:214-467-9787
Practice Address - Fax:469-949-9888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013137251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210306101Medicaid