Organization
GREEN ACRES COUNSELING AND GROUP SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN GREEN LIDCD.161732 (OWNER)
(216) 633-8644
Entity
Organization
Contact information
Practice address
3100 E 45TH ST STE 212C, CLEVELAND, OH 44127-1093
(216) 438-2846
Mailing address
2283 E 100TH ST, CLEVELAND, OH 44106-3501
(216) 633-8644
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0287012
—
OH
Enumeration date
05/23/2019
Last updated
03/30/2023
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