GRANITE WELLNESS CENTERS (NPI# 1912277864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912277864 |
| Entity Type | Organization |
| Organization Name | GRANITE WELLNESS CENTERS |
| Other Organization Name | COMMUNITY RECOVERY RESOURCES |
| Practice Address |
8491 North Lake Blvd. Kings Beach CA 96143 |
| Mailing Address |
Po Box 6028 Auburn CA 95604-6028 |
| Practice Telephone | 5305465641 |
| Practice Fax Number | 5305465480 |
| Mailing Telephone | 5308785166 |
| Mailing Fax Number | 9167978979 |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2019-05-22 |
| Authorized Official Name | KARYN RUBICK (ADMINISTRATIVE ASSOCIATE) |
| Authorized Official Telephone | 5308785166 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DRUG MEDI-CAL | 31AC | 01 |
| Other Name | Type Code |
|---|---|
| Community Recovery Resources | Former Legal Business Name - Organization |
| Kings Beach Service Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710257704 | Granite Wellness Centers | Community/Behavioral Health | 12183 Locksley Ln Ste 101-105, Auburn, CA 95602-2004 | 2012-01-06 |
| 1376727693 | Granite Wellness Centers | Community/Behavioral Health | 10015 Palisades Dr, Ste 1, Truckee, CA 96161-1901 | 2007-12-21 |
| 1255526042 | Granite Wellness Centers | Community/Behavioral Health | 730 Sunrise Ave Ste 200, Roseville, CA 95661-4549 | 2007-09-13 |
| 1376747709 | Granite Wellness Centers | Community/Behavioral Health | 1530 3rd St Ste 106, Lincoln, CA 95648-2500 | 2007-06-11 |
| 1518184621 | Granite Wellness Centers | Substance Abuse Rehabilitation Facility | 12125 Shale Ridge Ln, Auburn, CA 95602-8880 | 2007-04-19 |
| 1235644071 | Granite Wellness Centers | Substance Abuse Rehabilitation Facility | 145 Bost Ave, Nevada City, CA 95959-3249 | 2017-12-01 |
| 1285860403 | Granite Wellness Centers | Substance Abuse Rehabilitation Facility | 159 Brentwood Dr, Grass Valley, CA 95945-5703 | 2009-06-02 |
| 1750500237 | Granite Wellness Centers | Community/Behavioral Health | 180 Sierra College Dr, Grass Valley, CA 95945-5768 | 2007-04-24 |
| Street Address |
8491 NORTH LAKE BLVD. |
| City | KINGS BEACH |
| State | CA |
| Zip Code | 96143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483761 | Pamela Mccarthy Murphy | Acupuncturist | 8762 North Lake Blvd, Kings Beach, CA 96143 | 2020-03-26 |
| 1306324512 | Western Sierra Medical Clinic, Inc. | Clinic/Center | 8665 Salmon Avenue, Kings Beach, CA 96143 | 2018-07-31 |
| 1053859033 | Barbara Ricotta | Acupuncturist | 8611 N. Lake Bl., Kings Beach, CA 96143 | 2017-02-09 |
| 1588115067 | Susan Smith | Counselor | 8491 N. Lake Blvd., Kings Beach, CA 96143 | 2016-10-19 |
| 1649670837 | Karen Kucharski | Dentist | 8079 N. Lake Blvd, 202, Kings Beach, CA 96143 | 2014-08-26 |
| 1063825917 | Sherry Thompson | Pharmacist | 8245 North Lake Blvd, Kings Beach, CA 96143 | 2014-06-09 |
| 1588946859 | Richard Vanhalen Collins II | Pharmacist | 8245 North Lake Blv, Kings Beach, CA 96143 | 2011-09-13 |
| 1902107394 | William David Wickland | Dentist | 8233 Rainbow Avenue, Kings Beach, CA 96143 | 2010-11-16 |
| 1609177872 | Raymond Richard Wasson | Pharmacist | 7815 North Lake Blvd., Kings Beach, CA 96143 | 2010-11-04 |
| 1700057239 | Keri Lynn Gonsalves | Registered Nurse | 8645 North Lake Blvd., #c, Kings Beach, CA 96143 | 2008-03-12 |
| Find all providers in zip 96143 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881861 | Griselda Tuchan Pineda Marriage and Family Therapist Inc | Community/Behavioral Health | 2820 S Vermont Ave Ste 16, Los Angeles, CA 90007-2291 | 2020-11-04 |
| 1013518687 | Turning Point of Central California, Inc. | Community/Behavioral Health | 3636 N 1st St Ste 112, Fresno, CA 93726-6818 | 2020-11-02 |
| 1588264113 | Licensed Clinical Social Worker Community Alliance PC | Community/Behavioral Health | 301 S 23rd St, Richmond, CA 94804-2807 | 2020-11-01 |
| 1134729718 | Cynthia Felicia Delaney | Community/Behavioral Health | 4887 Bella Pacific Row Unit 240, San Diego, CA 92109-8515 | 2020-10-31 |
| 1114527637 | Clarke-lauren Stevenson Richard | Community/Behavioral Health | 1277 E Loma Linda Ave, Fresno, CA 93720-2668 | 2020-10-26 |
| 1891395232 | Jacqulyn Danielle Rios | Community/Behavioral Health | 4604 W Douglas Ave Apt 103, Visalia, CA 93291-4195 | 2020-10-26 |
| 1346849213 | Greystone Behavioral Health Nursing Inc | Community/Behavioral Health | 231 E Alessandro Blvd Ste A438, Riverside, CA 92508-5084 | 2020-10-22 |
| 1376142216 | Melissa Reyes Aguilar | Community/Behavioral Health | 2248 S Cochran Ave, Los Angeles, CA 90016-1218 | 2020-10-21 |
| 1578162616 | Bayfront Healthcare Services | Community/Behavioral Health | 2703 N Studebaker Rd, Long Beach, CA 90815-1628 | 2020-10-20 |
| 1326647686 | Sierra Child & Family Services | Community/Behavioral Health | 564 Mountain Ranch Rd Ste 5, San Andreas, CA 95249-9782 | 2020-10-19 |
| Find all providers with the same taxonomy | ||||
| City | KINGS BEACH |
| Zip Code | 96143 |
Please comment or provide details below to improve the information on GRANITE WELLNESS CENTERS.
| 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.