Healthcare Provider Details

I. General information

NPI: 1083545032
Provider Name (Legal Business Name): SIGNATURE HOME CARE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1579 E FLETCHER DR
CASA GRANDE AZ
85122-0806
US

IV. Provider business mailing address

1579 E FLETCHER DR
CASA GRANDE AZ
85122-0806
US

V. Phone/Fax

Practice location:
  • Phone: 520-413-8035
  • Fax:
Mailing address:
  • Phone: 520-413-8035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: GWENDOLYN HAYES
Title or Position: OWNER
Credential:
Phone: 520-413-8035