# GRANITE BAY CARE, INC

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

## Provider details

- **NPI number:** 1518022763
- **Authorized official:** MR. KASAI MUMPINI MBA (PRESIDENT & CEO)
- **Authorized official phone:** (603) 224-0044

## Contact information

- **Practice address:** 1037 FOREST AVE, PORTLAND, ME 04103-3396
- **Practice address phone:** (207) 878-3229
- **Practice address fax:** (207) 797-3018
- **Mailing address:** 5 WARREN ST, CONCORD, NH 03301-4044
- **Mailing address phone:** (603) 224-0044
- **Mailing address fax:** (603) 225-1175

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 07/22/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 417080000 | — | ME |