Healthcare Provider Details

I. General information

NPI: 1851792808
Provider Name (Legal Business Name): GRAND CANYON HOME HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2432 W PEORIA AVE STE 1073
PHOENIX AZ
85029-4730
US

IV. Provider business mailing address

2432 W PEORIA AVE STE 1073
PHOENIX AZ
85029-4730
US

V. Phone/Fax

Practice location:
  • Phone: 602-441-2722
  • Fax: 602-441-5022
Mailing address:
  • Phone: 602-441-2722
  • Fax: 602-441-5022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LINDA ABRAMOV
Title or Position: DIRECTOR OF OPERATIONS
Credential: DIRECTOR
Phone: 602-441-2722