Healthcare Provider Details

I. General information

NPI: 1548232150
Provider Name (Legal Business Name): GRANCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 24TH AVE
SANTA CRUZ CA
95062-4205
US

IV. Provider business mailing address

675 24TH AVE
SANTA CRUZ CA
95062-4205
US

V. Phone/Fax

Practice location:
  • Phone: 831-475-6323
  • Fax:
Mailing address:
  • Phone: 831-475-6323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. ANDREA J SAAVEDRA
Title or Position: REGIONAL FINANCIAL ANALYST
Credential: B.S.
Phone: 707-208-1940