Granite Wellness Centers | |
12183 Locksley Ln Ste 101-105 Auburn CA 95602-2004 | |
(530) 885-1961 | |
(530) 889-1304 |
Full Name | Granite Wellness Centers |
---|---|
Speciality | Community/behavioral Health |
Location | 12183 Locksley Ln Ste 101-105, Auburn, California |
Authorized Official Name and Position | Elaine Ebbert (OPERATIONS DIRECTOR) |
Authorized Official Contact | 5308785166 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Granite Wellness Centers Po Box 6028 Auburn CA 95604-6028 Ph: (530) 878-5166 | Granite Wellness Centers 12183 Locksley Ln Ste 101-105 Auburn CA 95602-2004 Ph: (530) 885-1961 |
NPI Number | 1710257704 |
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Provider Enumeration Date | 01/06/2012 |
Last Update Date | 09/22/2022 |
Certification Date | 09/22/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710257704 | NPI | - | NPPES |
31AC | Other | CA | MEDI-CAL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 310019AN (California) | Primary |
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