| Greenhouse Psychiatric Services Llc | |
|
113 Flagg Pl Bldg B Lafayette LA 70508-7025 | |
| (337) 247-7282 | |
| (337) 279-0776 |
| Full Name | Greenhouse Psychiatric Services Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 113 Flagg Pl Bldg B, Lafayette, Louisiana |
| Authorized Official Name and Position | Robert Allen Green (OWNER) |
| Authorized Official Contact | 3372477282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenhouse Psychiatric Services Llc 300 Highland View Dr Youngsville LA 70592-6080 Ph: (337) 247-7282 | Greenhouse Psychiatric Services Llc 113 Flagg Pl Bldg B Lafayette LA 70508-7025 Ph: (337) 247-7282 |
| NPI Number | 1669130621 |
|---|---|
| Provider Enumeration Date | 12/07/2021 |
| Last Update Date | 01/05/2023 |
| Certification Date | 01/05/2023 |
| Medicare PECOS PAC ID | 1254722911 |
|---|---|
| Medicare Enrollment ID | O20220107000033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669130621 | NPI | - | NPPES |
| Provider Name | Robert Allen Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487328464 PECOS PAC ID: 4789910365 Enrollment ID: I20211117000984 |
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