Five Star Granite Gate, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

FIVE STAR GRANITE GATE, LLC

Doing business as

Granite Gate Senior Living

Practice address

3850 North US Highway 89
Prescott, AZ 86301

Phone

(928) 771-8200

Fax

(928) 771-8213

NPI assigned

Jun 13, 2007

Organization subpart

Yes

Parent organization

FIVE STAR GRANITE GATE, LLCAs reported in NPPES

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

Authorized official

Name

Paul Hoagland

Title

Chief Financial Officer

Phone

(617) 796-8292

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Granite Gate Senior Living Doing business as

Part of

Five Star Granite Gate LLC

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315353600000",
    "number": "1811191943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CENTRE STREET",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "02458",
            "telephone_number": "617-796-8387",
            "fax_number": "617-796-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 NORTH US HIGHWAY 89",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86301",
            "telephone_number": "928-771-8200",
            "fax_number": "928-771-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR GRANITE GATE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR GRANITE GATE, LLC",
        "enumeration_date": "2007-06-13",
        "last_updated": "2011-09-07",
        "status": "A",
        "authorized_official_last_name": "HOAGLAND",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "617-796-8292"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALC-6120",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSISTED LIVING LICENSE",
            "identifier": "ALC-6120",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granite Gate Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kenneth Paul Finn, M.D.
• First Lab, LLC
• Tamara L Fischer, NP
• Marianne Fisher
• Melody Sue Fisher, L.M.
• Five Star Rehabilitation and Wellness Services, LLC. (Ageility Physical Therapy Solutions at Granite Gate)
• Kaylan Rose Flanigan, DMD
• Caitlin Flaum, LPC
• Robin M Fleck, MD
• Mary Jo Fleming, M.A. PROFESSIONAL CO

• Assisted Living Facility in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.