| Greenhouse For Mental Health Development P.c. | |
|
115 Route 46 W Bldg F Mountain Lakes NJ 07046-1668 | |
| (973) 722-0483 | |
| Not Available |
| Full Name | Greenhouse For Mental Health Development P.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 115 Route 46 W Bldg F, Mountain Lakes, New Jersey |
| Authorized Official Name and Position | Ayodele Green (PRESIDENT) |
| Authorized Official Contact | 9737220483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenhouse For Mental Health Development P.c. Po Box 282 Mountain Lakes NJ 07046-0282 Ph: () - | Greenhouse For Mental Health Development P.c. 115 Route 46 W Bldg F Mountain Lakes NJ 07046-1668 Ph: (973) 722-0483 |
| NPI Number | 1629856299 |
|---|---|
| Provider Enumeration Date | 09/15/2023 |
| Last Update Date | 09/15/2023 |
| Certification Date | 09/15/2023 |
| Medicare PECOS PAC ID | 4981051596 |
|---|---|
| Medicare Enrollment ID | O20231103000256 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629856299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Secondary |
| Provider Name | Ayodele Green |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598922866 PECOS PAC ID: 2365517471 Enrollment ID: I20080823000023 |
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