Healthcare Provider Details

I. General information

NPI: 1992634240
Provider Name (Legal Business Name): CARITAS HOME SUPPORT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35809 N ZINC DR
QUEEN CREEK AZ
85144-0372
US

IV. Provider business mailing address

35809 N ZINC DR
QUEEN CREEK AZ
85144-0372
US

V. Phone/Fax

Practice location:
  • Phone: 385-251-4542
  • Fax:
Mailing address:
  • Phone:
  • 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: STOCKTON BROCKBANK
Title or Position: OWNER
Credential:
Phone: 385-251-4542