Provider Demographics
NPI:1316629249
Name:GREEN ACRES WELLNESS LLC
Entity type:Organization
Organization Name:GREEN ACRES WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-812-9652
Mailing Address - Street 1:15320 US HIGHWAY 129
Mailing Address - Street 2:
Mailing Address - City:ALAPAHA
Mailing Address - State:GA
Mailing Address - Zip Code:31622-7351
Mailing Address - Country:US
Mailing Address - Phone:772-812-9652
Mailing Address - Fax:833-535-0164
Practice Address - Street 1:15320 US HIGHWAY 129
Practice Address - Street 2:
Practice Address - City:ALAPAHA
Practice Address - State:GA
Practice Address - Zip Code:31622-7351
Practice Address - Country:US
Practice Address - Phone:772-812-9652
Practice Address - Fax:833-535-0164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility