Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Grand Canyon Group Home LLC

Organization Case Management Agency · NPI 1750254850

Grand Canyon Group Home LLC is a Case Management Agency in Seffner, Florida. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
9
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

5208 Cherry Ave
Seffner, FL 33584-4406
Phone: (813) 810-6844
Fax: (813) 862-1072
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emotionally Disturbed Childrens' Residential Treatment Facility (primary) Taxonomy 322D00000X
Case Management Agency Taxonomy 251B00000X
Home Health Agency Taxonomy 251E00000X
Nursing Care Agency Taxonomy 251J00000X
Community/Behavioral Health Agency Taxonomy 251S00000X
Nursing Facility/Intermediate Care Facility Taxonomy 313M00000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility Taxonomy 320600000X
Physical Disabilities Residential Treatment Facility Taxonomy 320700000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Taxonomy 320900000X

Record details

NPI number1750254850
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationGrand Canyon Group Home LLC
Authorized official Cassandra Simpson — Executive Director · (813) 810-6844
NPI enumeratedSeptember 25, 2025
Last updated in NPPESSeptember 25, 2025
Certification dateSeptember 25, 2025
Mailing addressPo Box 963, Valrico, FL 33595-0963

Other providers in Seffner