GREEN TERRACE NPI 1598884835

NPI Information

  • NPI: 1598884835
  • Provider Name: GREEN TERRACE
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 821 26TH AVE SE
    MOULTRIE, GA
    ZIP 31768
  • Phone: (229) 985-0905

Map and Directions

Get Directions

NPI Details

GREEN TERRACE is an assisted living facility in Moultrie, GA. 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 TERRACE NPI is 1598884835. The provider is registered as an organization entity type.

The provider's business location address is:

821 26TH AVE SE
MOULTRIE, GA
ZIP 31768-769
Phone: (229) 985-0905
Fax: (229) 890-8130

The provider's authorized official is Thomas W Greene .
The authorized official title is Owner and has the following contact phone number (229) 985-0905.

The enumeration date for this NPI number is 3/28/2007 and was last updated on 8/22/2020.

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 FacilityGEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100744818AMEDICAIDGEORGIA

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: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI