Provider Demographics
NPI:1578911947
Name:GRANITE HEALTHCARE, INC.
Entity Type:Organization
Organization Name:GRANITE HEALTHCARE, INC.
Other - Org Name:NAMASTE HOME HEALTH AND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOCHNOUR
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:208-401-1365
Mailing Address - Street 1:6000 E EVANS AVE STE 3-111
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5422
Mailing Address - Country:US
Mailing Address - Phone:303-730-3578
Mailing Address - Fax:
Practice Address - Street 1:6000 E EVANS AVE STE 3-111
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5422
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:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty