Provider Demographics
NPI:1598427502
Name:GRANITE HOUSE OF HELP
Entity Type:Organization
Organization Name:GRANITE HOUSE OF HELP
Other - Org Name:GHH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CRISPIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-760-8715
Mailing Address - Street 1:84 KARATZAS AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-4851
Mailing Address - Country:US
Mailing Address - Phone:603-760-8715
Mailing Address - Fax:
Practice Address - Street 1:1100 VALLEY ST STE 4
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3532
Practice Address - Country:US
Practice Address - Phone:603-760-8715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH04529OtherHOME CARE LICENSE