Provider Demographics
NPI:1003197344
Name:GRANITE HEALTHCARE, INC.
Entity Type:Organization
Organization Name:GRANITE HEALTHCARE, INC.
Other - Org Name:NAMASTE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-401-1369
Mailing Address - Street 1:5161 E ARAPAHOE RD STE 320
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2385
Mailing Address - Country:US
Mailing Address - Phone:303-730-3578
Mailing Address - Fax:
Practice Address - Street 1:5161 E ARAPAHOE RD STE 320
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2385
Practice Address - Country:US
Practice Address - Phone:303-730-3578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-31
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
067471Medicare Oscar/Certification