# GRANITE HILLS HEALTHCARE, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Granite Hills Convalescent Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508953662
- **Authorized official:** MR. GARY D DEVOIR (PRESIDENT)
- **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 | — | CA | Yes |

## Other

- **Enumeration date:** 10/09/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT05392I | — | CA |