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General NPI Number Information
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NPI Number | 1275043770
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Entity Type | Organization
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Legal Business Name | GRANITE RIDGE HOME HEALTH NURSING CARE, INC.
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Dates
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Enumeration Date | 10/10/2017
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 1060 FULTON ST STE 714
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City | FRESNO
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State | CA
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Zip | 93721-2513
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Country | US
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Telephone | 559-977-3952
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Fax | 559-420-0310
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Provider Business Mailing Address
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Address Line | 1060 FULTON ST STE 714
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City | FRESNO
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State | CA
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Zip | 93721-2513
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Country | US
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Telephone | 559-977-3952
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Fax | 559-420-0310
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Authorized Official
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Title or Position | ASSISTANT ADMINISTRATOR
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Name | FRANK KELLY
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Credential | RN
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Telephone | 209-617-9625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 789398
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 789398
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WH1000X
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Taxonomy Name | Hospice Registered Nurse
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License Number | 789398
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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