Provider Demographics
NPI:1528061868
Name:GREEN HILL INC
Entity type:Organization
Organization Name:GREEN HILL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR - PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TONI LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA, MHA
Authorized Official - Phone:973-731-2300
Mailing Address - Street 1:103 PLEASANT VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2905
Mailing Address - Country:US
Mailing Address - Phone:973-731-2300
Mailing Address - Fax:973-325-6009
Practice Address - Street 1:103 PLEASANT VALLEY WAY
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2905
Practice Address - Country:US
Practice Address - Phone:973-731-2300
Practice Address - Fax:973-325-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ30C001310400000X
NJ030707314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0015458Medicaid
NJ0754Medicaid
NJ4476905Medicaid
NJ0015458Medicaid
NJ4476905Medicaid