Edgewood Casa Grande Az02 LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EDGEWOOD CASA GRANDE AZ02 LLC

Doing business as

Avista Senior Living Casa Grande

Practice address

1640 N Peart Rd
Casa Grande, AZ 85122-2564

Phone

(520) 280-0339

NPI assigned

Jun 11, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Dybwad

Title

VP Finance/Budget

Phone

(701) 738-2000

Specialties & licenses 1

Addresses

Other names 1

• Avista Senior Living Casa Grande Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1781136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781136000000",
    "number": "1508790833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13238",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582083238",
            "telephone_number": "701-738-2000",
            "fax_number": "701-738-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 N PEART RD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851222564",
            "telephone_number": "520-280-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD CASA GRANDE AZ02 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-11",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A",
        "authorized_official_last_name": "DYBWAD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP FINANCE/BUDGET",
        "authorized_official_telephone_number": "701-738-2000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avista Senior Living Casa Grande",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Providers in Casa Grande, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.