Provider Demographics
NPI:1396977237
Name:GREENFIELDS HEALTH SERVICES INC
Entity type:Organization
Organization Name:GREENFIELDS HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALCOHOL AND DRUG COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:VINCE
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:DEPLOMA
Authorized Official - Phone:323-901-2166
Mailing Address - Street 1:637 E ALBERTONI ST STE 109
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1543
Mailing Address - Country:US
Mailing Address - Phone:424-204-2703
Mailing Address - Fax:310-626-9754
Practice Address - Street 1:637 E ALBERTONI ST STE 109
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-1543
Practice Address - Country:US
Practice Address - Phone:424-204-2703
Practice Address - Fax:310-626-9754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA324500000X
CA190600AP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility