Healthcare Provider Details

I. General information

NPI: 1164095212
Provider Name (Legal Business Name): GRANDPARENTS OF AMERICA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9375 E SHEA BLVD STE 100
SCOTTSDALE AZ
85260-6986
US

IV. Provider business mailing address

9375 E SHEA BLVD STE 100
SCOTTSDALE AZ
85260-6986
US

V. Phone/Fax

Practice location:
  • Phone: 520-704-8310
  • Fax: 520-848-3611
Mailing address:
  • Phone: 520-704-8310
  • Fax: 520-848-3611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QP2400X
TaxonomyPrison Health Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JAMES JOSEPH ROSE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 520-204-7958