Provider Demographics
NPI:1699154369
Name:GREEN-DORSEY ENTERPRISES, LLC
Entity type:Organization
Organization Name:GREEN-DORSEY ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-748-8775
Mailing Address - Street 1:18715 RIVER MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-2240
Mailing Address - Country:US
Mailing Address - Phone:832-748-8775
Mailing Address - Fax:832-442-3394
Practice Address - Street 1:18715 RIVER MEADOWS RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-2240
Practice Address - Country:US
Practice Address - Phone:832-748-8775
Practice Address - Fax:832-442-3394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care