GREEN TREE RESIDENCE LLC NPI 1184425092

NPI Information

  • NPI: 1184425092
  • Provider Name: GREEN TREE RESIDENCE LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 13741 BURNING TREE DR
    VICTORVILLE, CA
    ZIP 92395
  • Phone: (760) 245-2504

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NPI Details

GREEN TREE RESIDENCE LLC is an assisted living facility in Victorville, CA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. GREEN TREE RESIDENCE LLC NPI is 1184425092. The provider is registered as an organization entity type.

The provider's business location address is:

13741 BURNING TREE DR
VICTORVILLE, CA
ZIP 92395-806
Phone: (760) 245-2504

The provider's authorized official is Martin Michael Ventress .
The authorized official title is Ceo and has the following contact phone number (424) 634-0093.

The enumeration date for this NPI number is 3/24/2025 and was last updated on 3/24/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes
23104A0630XAssisted Living FacilityAssisted Living, Behavioral DisturbancesNo
3311Z00000XCustodial Care FacilityNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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