GRAND CANYON HOME CARE INC.
GRAND CANYON HOME CARE - MESA · Technician (Attendant Care Provider)

Address: 420 E Southern Ave Ste 110a, Mesa, AZ 85204-4945

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
AZ 568006 MEDICAID

Other Provider/Organization Names

Other Name Type Code
grand canyon home care - MESA Doing Business As Name

Other providers with the same 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

Office Location

Street Address 420 E SOUTHERN AVE STE 110A
City MESA
State AZ
Zip Code 85204-4945

Providers in the same location

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

Providers in the same zip code prefix

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 Information

Taxonomy Code 3747A0650X
Grouping Nursing Service Related Providers
Classification Technician
Specialization Attendant Care Provider

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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

Competitor

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City MESA
Zip Code 85204

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Dataset Information

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.