GRANITE PATHWAYS, INC. (NPI# 1356818769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356818769 |
| Entity Type | Organization |
| Organization Name | GRANITE PATHWAYS, INC. |
| Practice Address |
1056 River Rd Manchester NH 03104-1958 |
| Practice Telephone | 8773690928 |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2019-11-13 |
| Authorized Official Name | MIA MARTIN (CFO, EASTER SEALS CENTRAL TEXAS) |
| Authorized Official Telephone | 5126156811 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities |
| Street Address |
1056 RIVER RD |
| City | MANCHESTER |
| State | NH |
| Zip Code | 03104-1958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104254424 | Christina Loder | Counselor | 1056 River Rd, Manchester, NH 03104-1958 | 2013-10-23 |
| 1386265023 | Manchester Youth Alliance, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 1056 River Rd, Manchester, NH 03104-1958 | 2020-05-05 |
| 1174085930 | Lorene Theresa Zammuto | Registered Nurse | 1056 River Rd, Manchester, NH 03104-1958 | 2019-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730675562 | Hannah E Boutselis | Nurse Practitioner | 1750 Elm St., Suite 201a, Manchester, NH 03104 | 2018-07-04 |
| 1366948770 | Families In Transition | Counselor | 15 Brook St, Manchester, NH 03104 | 2018-04-04 |
| 1528586872 | Nicole Mitchell | Physical Therapy Assistant | 235 Myrtle St., Manchester, NH 03104 | 2017-09-07 |
| 1851819270 | Community House Calls LLC | Contractor | 497 Hooksett Road, 232, Manchester, NH 03104 | 2017-09-06 |
| 1407207533 | Brianna Cassidy | Specialist/Technologist | 62 Jonathan Ln, Manchester, NH 03104 | 2016-06-30 |
| 1477926871 | Anthony Macri | Skilled Nursing Facility | 524 Blevens Dr., Manchester, NH 03104 | 2015-11-06 |
| 1225412935 | Families In Transition | Counselor | 136 Lowell St, Manchester, NH 03104 | 2015-07-13 |
| 1386036622 | Phoenix Rising Counseling Services, LLC | Counselor | 114 Bay Street, Suite A, Manchester, NH 03104 | 2015-02-24 |
| 1366795767 | Alicia M. Kleczkowski | Nurse Practitioner | 57 Webster St., Manchester, NH 03104 | 2012-10-23 |
| 1356615710 | Laurie Lagasse | Physical Therapy Assistant | 44 West Webster St, Manchester, NH 03104 | 2012-03-02 |
| Find all providers in zip 03104 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| City | MANCHESTER |
| Zip Code | 03104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.