Organization
GREENHOUSE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOKNOSH LISMON (CEO)
(317) 794-5070
Entity
Organization
Contact information
Practice address
1345 E CHANDLER BLVD BLDG 2, PHOENIX, AZ 85048-6279
(317) 794-5070
Mailing address
100 N HEARTHSTONE WAY APT 3168, CHANDLER, AZ 85226-0043
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/03/2022
Last updated
03/07/2023
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