Healthcare Provider Details

I. General information

NPI: 1003197344
Provider Name (Legal Business Name): GRANITE HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2011
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5161 E ARAPAHOE RD STE 320
CENTENNIAL CO
80122-2385
US

IV. Provider business mailing address

5161 E ARAPAHOE RD STE 320
CENTENNIAL CO
80122-2385
US

V. Phone/Fax

Practice location:
  • Phone: 303-730-3578
  • Fax:
Mailing address:
  • Phone: 303-730-3578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LEE JOHNSON
Title or Position: TREASURER
Credential:
Phone: 208-401-1369