Organization
73 NORTH OF GRANVILLE, INC.
Active
Other names
Holbrook Adult Home
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA HOLLISTER PAUQUETTE (ADMINISTRATOR/ OWNER)
(518) 642-3476
Entity
Organization
Contact information
Practice address
73 NORTH ST, GRANVILLE, NY 12832-1136
(518) 642-3476
(518) 642-3801
Mailing address
73 NORTH ST, GRANVILLE, NY 12832-1136
(518) 642-3476
(518) 642-3801
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
760-F-014
NY
Other
Enumeration date
03/19/2015
Last updated
03/19/2015
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