Healthcare Provider Details

I. General information

NPI: 1568328342
Provider Name (Legal Business Name): HOLY HOME CARE AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2025
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3014 S 72ND LN
PHOENIX AZ
85043-7823
US

IV. Provider business mailing address

3014 S 72ND LN
PHOENIX AZ
85043-7823
US

V. Phone/Fax

Practice location:
  • Phone: 480-930-9561
  • Fax:
Mailing address:
  • Phone: 480-930-9561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH GASANA
Title or Position: CEO
Credential:
Phone: 480-930-9561