NPIMap

Organization Active NPI

Granite Wellness Centers

  • Community/Behavioral Health Agency
  • Lincoln, CA
National Provider Identifier
1376747709
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
310019CN Issued in CA
Legal business name
GRANITE WELLNESS CENTERS
Practice address
1530 3Rd St Ste 106
Lincoln, CA 95648-2500
Phone
(916) 434-8927
Fax
(916) 434-0678
NPI assigned
Jun 11, 2007
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
Community/Behavioral Health Agency 251S00000X 310019CN CA Primary

Addresses

Primary practice location

1530 3Rd St Ste 106
Lincoln, CA 95648-2500

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
31AAOtherCADRUG MEDI-CAL

Other names 2

  • Lincoln Service Center 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.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1376747709",
    "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": "1530 3RD ST STE 106",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956482500",
            "telephone_number": "916-434-8927",
            "fax_number": "916-434-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE WELLNESS CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "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": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "310019CN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG MEDI-CAL",
            "identifier": "31AA",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln Service Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lincoln Service Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Recovery Resources",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lincoln, 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.