Grand Canyon Group Home LLC

NPI #1477278232 in Valrico, Florida

Provider Information

NPI Number
1477278232
Entity Type
Organization
Organization Name
Grand Canyon Group Home LLC
Primary Specialty
In Home Supportive Care
Enumeration Date
Oct 4, 2022
Last Updated
Oct 4, 2022

Practice Location

Address
949 GRAND CANYON DR
State
Florida
ZIP Code
33594-4351
Phone
(813) 530-0004

Authorized Official

Name
CASSANDRA VIRGINIA SIMPSON, BSN, RN
Title
DIRECTOR
Phone
(813) 810-6844

Specialties & Taxonomy Codes

Specialty
Home Health
Nursing Care
Clinic/Center - Developmental DisabilitiesDevelopmental Disabilities
Clinic/Center - Health ServiceHealth Service
Respite Care - Respite Care, Intellectual and/or Developmental Disabilities, ChildRespite Care, Intellectual and/or Developmental Disabilities, Child
In Home Supportive Care

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