# THE GREEN HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699772327
- **Authorized official:** ROGER C. YOST (CFO)
- **Authorized official phone:** (570) 321-3175

## Contact information

- **Practice address:** 37 CENTRAL AVE, WELLSBORO, PA 16901-1857
- **Practice address phone:** (570) 724-3131
- **Practice address fax:** (570) 724-2367
- **Mailing address:** 37 CENTRAL AVE, WELLSBORO, PA 16901-1857
- **Mailing address phone:** (570) 724-3131
- **Mailing address fax:** (570) 724-2367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 072202 | PA | Yes |

## Other

- **Enumeration date:** 07/07/2005
- **Last updated:** 02/05/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0007565790003 | — | PA |