Organization
GRANITE WELLNESS CENTERS
Active
Other names
Community Recovery Resources, Grass Valley Campus
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE EBBERT (OPERATIONS DIRECTOR)
(530) 878-5166
Entity
Organization
Contact information
Practice address
180 SIERRA COLLEGE DR, GRASS VALLEY, CA 95945-5768
(530) 273-9541
(530) 273-7740
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
290002AN
CA
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29AA
DRUG MEDI-CAL
CA
Enumeration date
04/24/2007
Last updated
09/22/2022
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