Organization
GREEN CROSS FOUNDATION INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHUKWUUEMEKA CHIDEBELU-EZE DC,MS (COFOUNDER)
(404) 671-9564
Entity
Organization
Contact information
Practice address
418 E 30TH ST, INDIANAPOLIS, IN 46205-3909
(317) 641-2026
Mailing address
3421 LEE RD, SNELLVILLE, GA 30039-5621
(317) 641-2026
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QC0050X
Critical Access Hospital Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QE0002X
Emergency Care Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR0208X
Mobile Radiology Clinic/Center
—
—
261QR1100X
Research Clinic/Center
—
—
335G00000X
Medical Foods Supplier
—
—
Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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