Provider Demographics
NPI:1689040735
Name:GCHA IN HOME CARE INC
Entity Type:Organization
Organization Name:GCHA IN HOME CARE INC
Other - Org Name:GENTLE CARE HOME ASSISTANCE
Other - Org Type:Other Name
Authorized Official - Title/Position:CO CEO
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-570-3691
Mailing Address - Street 1:4801 E MCKELLIPS RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-2527
Mailing Address - Country:US
Mailing Address - Phone:480-570-3691
Mailing Address - Fax:480-850-0228
Practice Address - Street 1:4801 E MCKELLIPS RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-2527
Practice Address - Country:US
Practice Address - Phone:480-570-3691
Practice Address - Fax:480-850-0228
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENTLE CARE HOME ASSISTANCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ025958OtherAHCCS