73 NORTH OF GRANVILLE, INC. (NPI# 1710371539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710371539 |
| Entity Type | Organization |
| Organization Name | 73 NORTH OF GRANVILLE, INC. |
| Other Organization Name | HOLBROOK ADULT HOME |
| Practice Address |
73 North St Granville NY 12832-1136 |
| Practice Telephone | 5186423476 |
| Practice Fax Number | 5186423801 |
| Mailing Telephone | 5186423476 |
| Mailing Fax Number | 5186423801 |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2015-03-19 |
| Authorized Official Name | DEBRA HOLLISTER PAUQUETTE (ADMINISTRATOR/ OWNER) |
| Authorized Official Telephone | 5186423476 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
760-F-014 | NY | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Holbrook Adult Home | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | 73 NORTH OF GRANVILLE, INC. | 73 North Street, Granville, New York 12832 |
| Street Address |
73 NORTH ST |
| City | GRANVILLE |
| State | NY |
| Zip Code | 12832-1136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851769541 | Freds Pharmacy LLC | Pharmacy | 75 Quaker Street, Granville, NY 12832 | 2015-09-11 |
| 1013353796 | Bianca B. Bernard | Registered Nurse | 84 East Potter Avenue, Granville, NY 12832 | 2013-05-21 |
| 1659693166 | Courtney Alexis Washburn | Pharmacist | 116 Quaker St, Granville, NY 12832 | 2010-02-25 |
| 1720114564 | Arnold Small | Dentist | The Orchard Nursing and Rehabilitation Centre, 10421state Route40, Granville, NY 12832 | 2007-02-26 |
| 1609933423 | Granville Central School District | Local Education Agency (LEA) | 58 Quaker St, Granville, NY 12832 | 2007-01-02 |
| 1891880944 | Anne E Riker | Physician Assistant | 17 Madison Street, Granville, NY 12832 | 2006-10-04 |
| 1881186930 | Brandy Lee Wadsworth | Registered Nurse | 79 North St, Granville, NY 12832 | 2018-06-05 |
| 1184933475 | Elizabethtown Community Hospital | General Acute Care Hospital | 66 Park Street, Suite 100, Elizabethtown, NY 12832-0000 | 2010-10-04 |
| 1942653852 | Laurie Ann Dennison | Registered Nurse | 15 Pine St, Granville, NY 12832-1111 | 2016-07-15 |
| 1952873259 | Michelle Parbus | Physician Assistant | 24 Pine St, Granville, NY 12832-1127 | 2018-12-26 |
| Find all providers in zip 12832 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
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| 1477116457 | Caroline S Reuben | Custodial Care Facility | 17108 Jamaica Ave, Jamaica, NY 11432-5428 | 2019-04-16 |
| 1255898979 | Yan K Chan | Custodial Care Facility | 6504 Bay Pkwy, Brooklyn, NY 11204-3931 | 2019-02-28 |
| 1609357284 | Sun Sunshine Adult Daycare Ctr Inc | Custodial Care Facility | 738 58th St, Brooklyn, NY 11220-3917 | 2018-08-22 |
| 1285113548 | The House of Hope | Custodial Care Facility | 31 Standish Rd, Valley Stream, NY 11580-1131 | 2018-08-08 |
| 1083112940 | True Quality Care | Custodial Care Facility | 1616 Chili Ave, Rochester, NY 14624-3246 | 2018-01-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.