Organization
GRANITE WELLNESS CENTERS
Active
Organization
GRANITE WELLNESS CENTERS
Active
Other names
Community Recovery Resources, Auburn Campus
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE EBBERT (OPERATIONS DIRECTOR)
(530) 878-5166
Entity
Organization
Contact information
Practice address
12183 LOCKSLEY LN STE 101-105, AUBURN, CA 95602-2004
(530) 885-1961
(530) 889-1304
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
310019AN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31AC
MEDI-CAL
CA
Enumeration date
01/06/2012
Last updated
09/22/2022
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