Granite Bay Countryhouse LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GRANITE BAY COUNTRYHOUSE LLC

Practice address

8485 Barton Rd
Granite Bay, CA 95746-9356

Phone

(916) 899-6565

NPI assigned

Jun 12, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stacy Randels

Title

VP Asset Management

Phone

(531) 800-3364

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1013802545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8485 BARTON RD",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957469356",
            "telephone_number": "916-899-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8485 BARTON RD",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957469356",
            "telephone_number": "916-899-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE BAY COUNTRYHOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "RANDELS",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "VP ASSET MANAGEMENT",
        "authorized_official_telephone_number": "531-800-3364"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Gonzales, NURSE
• Breanna Gonzalez
• Elizabeth Gonzalez
• Lauren Goodman
• Jon Austin Gorman, THERAPIST
• Granite Bay Pharmacy Advisors Inc
• Granite Bay Physical Therapy
• Granite Bay Vision Center Optometry, Inc.
• Granite Pointe Psychiatry Group, Inc.
• Julee Greeson

• Assisted Living Facility in Granite Bay, CA
• Providers in Granite Bay, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.