Organization
GRANVILLE HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES GROSS (EXECUTIVE DIRECTOR)
(919) 692-1315
Entity
Organization
Contact information
Practice address
200 COVENTRY DR, OXFORD, NC 27565-4005
(919) 692-1315
(919) 692-1363
Mailing address
200 COVENTRY DRIVE, OXFORD, NC 27565
(919) 692-1315
(919) 692-1363
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL- 039-009
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7804060
PROVIDER NUMBER
NC
Enumeration date
01/05/2007
Last updated
01/02/2008
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