Organization
GRAND CANYON HOME CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YAKOV YUSHUVAYEV (PRESIDENT)
(917) 864-3328
Entity
Organization
Contact information
Practice address
13201 N 35TH AVE STE 1B, PHOENIX, AZ 85029-1231
(602) 795-0222
(602) 795-0080
Mailing address
13201 N 35TH AVE STE 1B, PHOENIX, AZ 85029-1231
(602) 795-0222
(602) 795-0080
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
12/01/2010
Last updated
03/31/2023
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