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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