Grand Canyon Home Care INC.
Technician, Attendant Care Provider in Phoenix, AZ. Organization (NPI-2).
NPI number1972805679
StatusActive
Last updated in NPPESMar 31, 2023
Details
- NPI
- 1972805679
- Entity type
- Organization (NPI-2)
- Legal business name
- Grand Canyon Home Care INC.
- Organization subpart
- No
- Enumeration date
- Dec 1, 2010
- Certification date
- Mar 31, 2023
- Last updated
- Mar 31, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747A0650X | Technician, Attendant Care Provider | – | – | Yes |
Practice location
13201 N 35th Ave Ste 1bPhoenix, AZ 85029-1231
Phone 602-795-0222 · Fax 602-795-0080
Mailing address
13201 N 35th Ave Ste 1bPhoenix, AZ 85029-1231
Phone 602-795-0222 · Fax 602-795-0080
Authorized official
Yakov Yushuvayev
President
9178643328
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