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Organization
GREEN CANARY HEALTH SYSTEMS
Active
Organization
GREEN CANARY HEALTH SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTEL TATUM (CHIEF EXECUTIVE OFFICER)
(404) 528-0297
Entity
Organization
Contact information
Practice address
6470 E JOHNS XING STE 160, JOHNS CREEK, GA 30097-1500
(404) 528-0297
Mailing address
6470 E JOHNS XING STE 160, JOHNS CREEK, GA 30097-1500
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
335E00000X
Prosthetic/Orthotic Supplier
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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