# GRACE HOME CARE ARIZONA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023972064
- **Authorized official:** MOHAMUD MOHAMUD (OWNER)
- **Authorized official phone:** (280) 210-9797

## Contact information

- **Practice address:** 11240 N 19TH AVE STE 22-1038, PHOENIX, AZ 85029-4825
- **Practice address phone:** (480) 210-9797
- **Mailing address:** 11240 N 19TH AVE STE 22-1038, PHOENIX, AZ 85029-4825
- **Mailing address phone:** (480) 210-9797

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/15/2025
- **Last updated:** 12/15/2025