Organization
GRANITE WELLNESS CENTERS
Active
Organization
GRANITE WELLNESS CENTERS
Active
Other names
Community Recovery Resources, Truckee Service Center
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE EBBERT (OPERATIONS DIRECTOR)
(530) 878-5166
Entity
Organization
Contact information
Practice address
10015 PALISADES DR, STE 1, TRUCKEE, CA 96161-1901
(530) 587-8194
Mailing address
PO BOX 6028, AUBURN, CA 95604-6028
(530) 878-5166
(916) 797-8979
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
290002DN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29AB
DRUG MEDI-CAL
CA
Enumeration date
12/21/2007
Last updated
09/22/2022
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