Provider Demographics
NPI:1356933725
Name:GRANITE HOUSE OF HELP LLC
Entity type:Organization
Organization Name:GRANITE HOUSE OF HELP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRISPIN
Authorized Official - Middle Name:LUNUAMA
Authorized Official - Last Name:MILELE
Authorized Official - Suffix:
Authorized Official - Credentials:BUSINESS SPECIALIST
Authorized Official - Phone:603-538-3300
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 1:84 KARATZAS AVE APT 203
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-4851
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:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care