| NPI | 1295213544 |
|---|---|
| Doing Business As | GRAND CANYON HOME CARE - MESA |
| Entity Type | Organization |
| Authorized Contact | YAKOV YUSHUVAYEV President 907-222-7666 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3747A0650X Technician Attendant Care Provider |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |