Organization
FIVE STAR GRANITE GATE, LLC
Active
Organization
FIVE STAR GRANITE GATE, LLC
Active
Parent organization
FIVE STAR GRANITE GATE, LLC
Other names
Granite Gate Senior Living
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIVE STAR GRANITE GATE, LLC
Authorized official
PAUL HOAGLAND (CHIEF FINANCIAL OFFICER)
(617) 796-8292
Entity
Organization
Contact information
Practice address
3850 NORTH US HIGHWAY 89, PRESCOTT, AZ 86301
(928) 771-8200
(928) 771-8213
Mailing address
400 CENTRE STREET, NEWTON, MA 02458
(617) 796-8387
(617) 796-8385
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
ALC-6120
AZ
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ALC-6120
ASSISTED LIVING LICENSE
AZ
Enumeration date
06/13/2007
Last updated
09/07/2011
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