# GREEN CANARY HEALTH SYSTEMS

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

## Provider details

- **NPI number:** 1831962216
- **Authorized official:** SHANTEL TATUM (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (404) 528-0297

## Contact information

- **Practice address:** 6470 E JOHNS XING STE 160, JOHNS CREEK, GA 30097-1500
- **Practice address phone:** (404) 528-0297
- **Mailing address:** 6470 E JOHNS XING STE 160, JOHNS CREEK, GA 30097-1500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 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