Organization
THE GRANITE HOUSE SOBER LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY QUATTROCCHI (DIRECTOR OF COMPLIANCE)
(603) 328-8601
Entity
Organization
Contact information
Practice address
35 W BROADWAY, DERRY, NH 03038-2375
(603) 328-8601
Mailing address
6 MANOR PKWY, SALEM, NH 03079-2841
(603) 328-8601
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04710
LICENSE TO OPERATE - SUBSTANCE USE DISORDER RES TREATMENT
NH
Enumeration date
02/11/2020
Last updated
12/21/2023
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