Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
GRAND CANYON GROUP HOME LLC
Active
Organization
GRAND CANYON GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA VIRGINIA SIMPSON BSN, RN (DIRECTOR)
(813) 810-6844
Entity
Organization
Contact information
Practice address
949 GRAND CANYON DR, VALRICO, FL 33594-4351
(813) 530-0004
(813) 862-1072
Mailing address
PO BOX 963, VALRICO, FL 33595-0963
(813) 530-0004
(813) 862-1072
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
NULL
251J00000X
Nursing Care Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
261QH0100X
Health Service Clinic/Center
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Enumeration date
10/04/2022
Last updated
10/04/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers