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General NPI Number Information
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NPI Number | 1164425583
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Entity Type | Organization
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Legal Business Name | GRANITE VNA, INC.
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 30 PILLSBURY ST
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City | CONCORD
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State | NH
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Zip | 03301-3502
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Country | US
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Telephone | 603-224-4093
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Fax | 603-227-7522
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Provider Business Mailing Address
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Address Line | 30 PILLSBURY ST
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City | CONCORD
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State | NH
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Zip | 03301-3502
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Country | US
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Telephone | 603-224-4093
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Fax | 603-230-5687
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Authorized Official
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Title or Position | DIRECTOR OF COMPLIANCE
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Name | MRS. LORI NASH
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Credential | MDM
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Telephone | 603-224-4093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 03500
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 03500
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License Number State | NH
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