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Contact Information

GRANITE WELLNESS CENTERS
8491 NORTH LAKE BLVD.
KINGS BEACH, CA96143
 Phone: 530-546-5641
 Fax: 530-546-5480
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for GRANITE WELLNESS CENTERS

NPI # 1912277864
LBN Legal business name GRANITE WELLNESS CENTERS
Authorized official KARYN RUBICK - (ADMINISTRATIVE ASSOCIATE)
Entity Organization
Organization subpart 1 No
Enumeration date 01/10/2012
Last updated 09/22/2022 - About 4 years ago
Identifiers
CA Other 31AC DRUG MEDI-CAL
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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