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General NPI Number Information
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NPI Number | 1760832505
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Entity Type | Organization
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Legal Business Name | GRANITE PATHWAYS
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Dates
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Enumeration Date | 06/13/2016
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 115 HERITAGE AVE
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City | PORTSMOUTH
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State | NH
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Zip | 03801-5610
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Country | US
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Telephone | 877-369-0928
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Fax | 603-570-9447
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Provider Business Mailing Address
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Address Line | 633 3RD AVE FL 6
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City | NEW YORK
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State | NY
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Zip | 10017-6733
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Country | US
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Telephone | 817-542-1988
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Fax | 866-834-4570
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Authorized Official
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Title or Position | CFO
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Name | CAROL KHOURY
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Credential |
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Telephone | 877-525-9203
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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 |
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License Number State |
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