# GREENRIVER ACADEMY

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

## Provider details

- **NPI number:** 1881201333
- **Authorized official:** REBEKAH MARIE NICHOLSON-LILLY (SPEECH PATHOLOGIST)
- **Authorized official phone:** (304) 667-3448

## Contact information

- **Practice address:** 722 MAIN ST E, WHITE SULPHUR SPRINGS, WV 24986-3002
- **Practice address phone:** (130) 466-7344
- **Mailing address:** 722 MAIN ST E, WHITE SULPHUR SPRINGS, WV 24986-3002
- **Mailing address phone:** (130) 466-7344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/29/2020
- **Last updated:** 09/29/2020