GRAND CANYON HOME CARE INC. (NPI# 1295213544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295213544 |
| Entity Type | Organization |
| Organization Name | GRAND CANYON HOME CARE INC. |
| Other Organization Name | GRAND CANYON HOME CARE - MESA (Doing Business As Name) |
| Practice Address | 420 E Southern Ave Ste 110a Mesa AZ 85204-4945 |
| Practice Telephone | 4803976010 |
| Mailing Address | 13201 N 35th Ave Ste 4b Phoenix AZ 85029-1231 |
| Mailing Telephone | 6027950222 |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |
| Authorized Official Telephone | 9072227666 |
| Is Organization Subpart | Y |
| Parent Organization Name | GRAND CANYON HOME CARE |
| Primary | Taxonomy Code | Classification | Taxonomy Group | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|---|
| Y | 3747A0650X | Technician Specialization: Attendant Care Provider | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 568006 | MEDICAID |
| Other Name | Type Code |
|---|---|
| grand canyon home care - MESA | Doing Business As Name |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972805679 | Grand Canyon Home Care Inc. | 13201 N 35th Ave Ste 15b, Phoenix, AZ 85029-1232 | 2010-12-01 |
| Street Address | 420 E SOUTHERN AVE STE 110A |
| City | MESA |
| State | AZ |
| Zip Code | 85204-4945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225516578 | Yakov Yushuvayev | Technician · Attendant Care Provider | 420 E Southern Ave Ste 110a, Mesa, AZ 85204-4945 | 2018-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194374819 | Luminations Healing Center, LLC | Social Worker · Clinical | 1237 S. Val Vista Dr. #221, Mesa, AZ 85204 | 2019-09-05 |
| 1881160356 | Wanjiru Landers | Student in an Organized Health Care Education/Training Program | 550 S Linda Circle, Mesa, AZ 85204 | 2018-10-22 |
| 1649754235 | Adam Desnous | Specialist/Technologist · Speech-Language Assistant | 751 S Daley, Mesa, AZ 85204 | 2018-09-19 |
| 1982128187 | Michael Anthony Jones | Counselor · Addiction (Substance Use Disorder) | 1107 North Gilbert Rd, Mesa, AZ 85204 | 2017-07-29 |
| 1295287225 | Scottsdale Healthcare Corp | Family Medicine | 2530 W. Southern Ave, Mesa, AZ 85204 | 2016-10-25 |
| 1427504158 | Richard White | Physician Assistant | 2345 E Southern Ave # 101, Mesa, AZ 85204 | 2016-09-01 |
| 1548716780 | Pain Stop Accident Injury LLC | Chiropractor | 425 E 11th Ave, Mesa, AZ 85204 | 2016-08-28 |
| 1154704252 | Glenn Taylor Lesueur | Dentist | 1056 S. Val Vista Dr., Suite 1, Mesa, AZ 85204 | 2015-07-07 |
| 1073932513 | Naomi Devine | Nurse Practitioner · Family | 1840 South Stapley Drive, Suite 101, Mesa, AZ 85204 | 2014-04-14 |
| 1609292531 | John Kamau | Counselor · Mental Health | 1060 S Lobin Ln, Mesa, AZ 85204 | 2014-03-17 |
| Find all providers in zip 85204 | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770191181 | Valerie Ann Beuschlein | 1507 N Sterling, Mesa, AZ 85207-3830 | 2020-07-21 | |
| 1487292173 | Amber P Bradshaw | 2855 S Extension Rd Unit 259, Mesa, AZ 85210-8282 | 2019-12-13 | |
| 1982255089 | Wendy Clement | 2219 S El Marino, Mesa, AZ 85202-6471 | 2019-09-20 | |
| 1891343760 | Dionne Nick | 4135 E Crescent Ave, Mesa, AZ 85206-1950 | 2019-09-03 | |
| 1962050211 | Ruby Evans | 11332 E Solina Cir, Mesa, AZ 85212-7038 | 2019-08-29 | |
| 1306494794 | Joann Domzalski | 857 E 8th Pl, Mesa, AZ 85203-5605 | 2019-08-28 | |
| 1043867351 | Michelle Guy | 10452 E Irwin Cir, Mesa, AZ 85209-7722 | 2019-08-21 | |
| 1952967788 | Janice Marie Armstrong | 461 N Yucca Cir, Mesa, AZ 85201-4551 | 2019-05-16 | |
| 1225516578 | Yakov Yushuvayev | 420 E Southern Ave Ste 110a, Mesa, AZ 85204-4945 | 2018-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427640028 | Absolute Hcbs | 4700 S Mcclintock Dr Ste 150, Tempe, AZ 85282-7375 | 2021-02-05 | |
| 1326639733 | Mountain View Home Care, LLC | County Rd 444, 1.5 Mi Ne, Tsaile, AZ 86556 | 2021-01-28 | |
| 1538760525 | Ayomikun Ajulo | 7426 W Cheryl Dr, Peoria, AZ 85345-6723 | 2020-11-05 | |
| 1306458609 | Tammy Kloser | 21738 N 91st Ln, Peoria, AZ 85382-8345 | 2020-08-18 | |
| 1770191181 | Valerie Ann Beuschlein | 1507 N Sterling, Mesa, AZ 85207-3830 | 2020-07-21 | |
| 1669090114 | Rogers K Bagia | 3141 W Maldonado Rd, Phoenix, AZ 85041-6372 | 2020-07-10 | |
| 1780201087 | Jovanna A Noriega | 4533 E Rolling Ridge Rd, San Tan Valley, AZ 85140-9576 | 2020-07-02 | |
| 1689291320 | Andrew Young | 9980 N Hacienda Hermosa Dr, Tucson, AZ 85737-3645 | 2020-06-29 | |
| 1730706730 | Shindona Duffey | 16069 W Sierra St, Goodyear, AZ 85338-3575 | 2020-06-25 | |
| 1679197883 | Amanda Lee Pethers | 13820 S 44th St Apt 1129, Phoenix, AZ 85044-4857 | 2020-06-03 | |
| Find all providers in the same taxonomy | ||||
| City | MESA |
| Zip Code | 85204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508312216 | Riverside Home Care, LLC | In Home Supportive Care | 949 Grand Canyon Dr, Valrico, FL 33594-4351 | 2016-09-01 |
| 1366774044 | North Country Healthcare Inc. · Grand Canyon Urgent Care | Clinic/Center · Urgent Care | 1 Clinic Road, Grand Canyon, AZ 86023 | 2010-02-05 |
| 1265976070 | Canyon Idaho Home Care & Hospice, LLC · Canyon Home Care & Hospice | Hospice Care, Community Based | 1705 Main St, Ste. 101, Baker City, OR 97814-3453 | 2016-12-13 |
| 1326559444 | Canyon Colorado Home Care & Hospice · Canyon Home Care & Hospice | Home Health | 1200 S Parker Rd Ste 102, Denver, CO 80231-7500 | 2017-10-16 |
| 1306485313 | Canyon Arizona Home Care & Hospice LLC · Canyon Home Care & Hospice | Hospice Care, Community Based | 7878 N 16th St Ste 155, Phoenix, AZ 85020-4449 | 2019-12-23 |
| 1083801963 | My Choice In-Home Care LLC · My Choice In-Home Care | Respite Care | 31610 Railroad Canyon Rd Ste 5, Canyon Lake, CA 92587-9454 | 2007-09-25 |
| 1386188191 | Canyon Idaho Home Care & Hospice, LLC · Canyon Home Care & Hospice | Hospice Care, Community Based | 929 Nw 16th St, Fruitland, ID 83619-2256 | 2016-12-13 |
| 1134606890 | Canyon Lake Senior Home Care Inc. · Canyon Lake Senior Home Care | In Home Supportive Care | 1215 Highland Terrace Dr, Canyon Lake, TX 78133-5274 | 2018-07-25 |
| 1033456967 | Grand Canyon Education, Inc. · Grand Canyon University | Clinic/Center · Student Health | 3300 W Camelback Rd, Canyon Health & Wellness Clinic, Phoenix, AZ 85017-3030 | 2013-01-11 |
| 1922520675 | Canyon Nevada LLC · Canyon Home Care & Hospice | Hospice Care, Community Based | 400 Shadow Ln Ste 202, Las Vegas, NV 89106-4358 | 2017-07-14 |
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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.