Granville Assisted Living - Paradise Retreat LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GRANVILLE ASSISTED LIVING - PARADISE RETREAT LLC

Practice address

5420 N Dolan CT
Prescott Valley, AZ 86314-6753

Phone

(626) 464-4379

NPI assigned

Sep 30, 2025

Last updated

Sep 30, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gerald Anthony Martin, MASTER'S DEGREE

Title

Owner

Phone

(626) 464-4379

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Songhui Martin, RN, PA

  • Registered Nurse
  • Prescott Valley, AZ
  • NPI 1720813587
  NPD

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

{
    "created_epoch": "1759190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759190400000",
    "number": "1902770308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 N DOLAN CT",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863146753",
            "telephone_number": "626-464-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 N DOLAN CT",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863146753",
            "telephone_number": "626-464-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANVILLE ASSISTED LIVING - PARADISE RETREAT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-30",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-464-4379",
        "authorized_official_credential": "MASTER'S DEGREE"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Whitney Goodell III, LPC
• Kimberly Gould, NP
• Angie J Graham, PSY.D.
• Granite Mountain Behavioral Health Care of Az, LLC
• Granite Orthopaedics, PLLC
• Michael C Grato
• Lisa Mae Diane Graveline, PMHNP-BC, APRN-RNP
• Loleita Leanora Green-Reid, APRN-FNP
• Tanya Renae Green, MT
• Gary Howard Greene, O.D.

• Assisted Living Facility in Prescott Valley, AZ
• Providers in Prescott Valley, 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 30, 2025; 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.