Provider Demographics
NPI:1093312282
Name:TRUGRANITE SERVICE COORDINATION LLC
Entity Type:Organization
Organization Name:TRUGRANITE SERVICE COORDINATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-575-5466
Mailing Address - Street 1:111 SARANAC ST STE 8
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-4090
Mailing Address - Country:US
Mailing Address - Phone:603-575-5466
Mailing Address - Fax:603-575-5703
Practice Address - Street 1:111 SARANAC ST STE 8
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-4090
Practice Address - Country:US
Practice Address - Phone:603-575-5466
Practice Address - Fax:603-575-5703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management