# 73 NORTH OF GRANVILLE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Holbrook Adult Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710371539
- **Authorized official:** DEBRA HOLLISTER PAUQUETTE (ADMINISTRATOR/ OWNER)
- **Authorized official phone:** (518) 642-3476

## Contact information

- **Practice address:** 73 NORTH ST, GRANVILLE, NY 12832-1136
- **Practice address phone:** (518) 642-3476
- **Practice address fax:** (518) 642-3801
- **Mailing address:** 73 NORTH ST, GRANVILLE, NY 12832-1136
- **Mailing address phone:** (518) 642-3476
- **Mailing address fax:** (518) 642-3801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 760-F-014 | NY | Yes |

## Other

- **Enumeration date:** 03/19/2015
- **Last updated:** 03/19/2015