Organization
THE GREEN HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER C. YOST (CFO)
(570) 321-3175
Entity
Organization
Contact information
Practice address
37 CENTRAL AVE, WELLSBORO, PA 16901-1857
(570) 724-3131
(570) 724-2367
Mailing address
37 CENTRAL AVE, WELLSBORO, PA 16901-1857
(570) 724-3131
(570) 724-2367
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
072202
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007565790003
—
PA
Enumeration date
07/07/2005
Last updated
02/05/2025
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