# GRANITE HILLS CONVALESCENT HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134494826
- **Authorized official:** MR. LARRY BLITZ (INTERIM MANAGER)
- **Authorized official phone:** (619) 447-1020

## Contact information

- **Practice address:** 1340 E MADISON AVE, EL CAJON, CA 92021-8501
- **Practice address phone:** (619) 447-1020
- **Practice address fax:** (619) 447-1024
- **Mailing address:** 1340 E MADISON AVE, EL CAJON, CA 92021-8501
- **Mailing address phone:** (619) 447-1020
- **Mailing address fax:** (619) 447-1024

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 090000097 | CA | Yes |

## Other

- **Enumeration date:** 03/14/2012
- **Last updated:** 03/14/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | CA080000086 | — | CA |