Granite Care Home, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

800919-2-RS Issued in MN

Legal business name

GRANITE CARE HOME, INC.

Practice address

202 2ND Ave S
Sauk Rapids, MN 56379-1412

Phone

(320) 251-4736

Fax

(320) 654-6584

NPI assigned

Apr 26, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Charlotte Kay Dhein, QMRP

Title

Program Director

Phone

(320) 251-4736

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326268194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 2ND AVE S",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791412",
            "telephone_number": "320-251-4736",
            "fax_number": "320-654-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 2ND AVE S",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791412",
            "telephone_number": "320-251-4736",
            "fax_number": "320-654-6584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE CARE HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DHEIN",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "320-251-4736",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "QMRP"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "MN",
            "license": "800919-2-RS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual Disabilities Intermediate Care Facility in Sauk Rapids, MN
• Providers in Sauk Rapids, MN by specialty
• Intellectual Disabilities Intermediate Care Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.