NPIMap

Organization Active NPI

Granite Wellness Centers

Doing business as Grass Valley Campus Residential Program

  • Substance Abuse Rehabilitation Facility
  • Grass Valley, CA
National Provider Identifier
1285860403
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
290002BN Issued in CA
Legal business name
GRANITE WELLNESS CENTERS
Doing business as
Grass Valley Campus Residential Program
Practice address
159 Brentwood Dr
Grass Valley, CA 95945-5703
Phone
(530) 273-9541
Fax
(530) 271-7036
NPI assigned
Jun 2, 2009
Last updated
Sep 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Authorized official

Name
Elaine Ebbert
Title
Operations Director
Phone
(530) 878-5166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 290002BN CA Primary

Addresses

Primary practice location

159 Brentwood Dr
Grass Valley, CA 95945-5703

Mailing address

PO Box 6028
Auburn, CA 95604-6028
Phone (530) 878-5166

Other names 2

  • Grass Valley Campus Residential Program Doing business as
  • Community Recovery Resources Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Community Recovery Resources8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

159 Brentwood Dr
Grass Valley, CA 95945
Phone (530) 271-1140

Practitioners & affiliated clinicians

Practitioners 66

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1285860403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6028",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956046028",
            "telephone_number": "530-878-5166",
            "fax_number": "916-797-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 BRENTWOOD DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455703",
            "telephone_number": "530-273-9541",
            "fax_number": "530-271-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE WELLNESS CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "EBBERT",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "530-878-5166"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "290002BN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grass Valley Campus Residential Program",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Recovery Resources",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.