Granville Assisted Living, LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

GRANVILLE ASSISTED LIVING, LLC

Practice address

5807 Granville Parkway
La Vista, NE 68128

Phone

(402) 933-6405

Fax

(402) 505-9144

NPI assigned

Jun 26, 2007

Organization subpart

No

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

Authorized official

Name

Mr. John Holtz

Title

Controller

Phone

(541) 747-3373

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1730385709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 CENTENNIAL LOOP",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974017900",
            "telephone_number": "541-747-3373",
            "fax_number": "541-747-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5807 GRANVILLE PARKWAY",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "68128",
            "telephone_number": "402-933-6405",
            "fax_number": "402-505-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANVILLE ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "HOLTZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "541-747-3373",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Goodman
• Lual Gout
• Shol K Gout
• Jenna Leigh Graeve, DPT
• Anthony Grant
• Rebekah Green
• Christopher Griffis, PA-C, LAT, ATC
• Christine Grimo
• Connie Grover
• Rina Del Carmen Gutierrez

• Point of Service in La Vista, NE
• Providers in La Vista, NE by specialty
• Point of Service in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.