Organization
GRANITE HILLS CONVALESCENT HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY BLITZ (INTERIM MANAGER)
(619) 447-1020
Entity
Organization
Contact information
Practice address
1340 E MADISON AVE, EL CAJON, CA 92021-8501
(619) 447-1020
(619) 447-1024
Mailing address
1340 E MADISON AVE, EL CAJON, CA 92021-8501
(619) 447-1020
(619) 447-1024
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
090000097
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CA080000086
—
CA
Enumeration date
03/14/2012
Last updated
03/14/2012
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