Estancia Assisted Living at Avoca Place, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ESTANCIA ASSISTED LIVING AT AVOCA PLACE, LLC

Practice address

2237 N Avoca
Mesa, AZ 85207-2028

Phone

(480) 561-5590

Fax

(409) 908-4682

NPI assigned

May 23, 2025

Organization subpart

No

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

Authorized official

Name

Dustin Godfrey

Title

Coo

Phone

(480) 561-5590

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1558154559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16543 E ELGIN ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952003",
            "telephone_number": "480-561-5590",
            "fax_number": "409-908-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2237 N AVOCA",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852072028",
            "telephone_number": "480-561-5590",
            "fax_number": "409-908-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTANCIA ASSISTED LIVING AT AVOCA PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "GODFREY",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "480-561-5590"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177782",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Mesa, AZ
• Providers in Mesa, 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 May 23, 2025; 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.