Active NPI
Az Assisted Living, LLC
- Assisted Living Facility
- Queen Creek, AZ
National Provider Identifier
1588577852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- AZ ASSISTED LIVING, LLC
- Practice address
- 21894 S 199TH Way
Queen Creek, AZ 85142-7364 - Phone
- (480) 834-8000
- Fax
- (877) 834-8008
- NPI assigned
- Sep 25, 2026
- Last updated
- Sep 25, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brady Garrard
- Title
- Owner
- Phone
- (480) 834-8000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | NU | Primary |
Addresses
Primary practice location
21894 S 199TH Way
Queen Creek, AZ 85142-7364
Mailing address
21894 S 199TH Way
Queen Creek, AZ 85142-7364
Phone (480) 834-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 167566 | Medicaid | AZ |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790294400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790294400000",
"number": "1588577852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21894 S 199TH WAY",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851427364",
"telephone_number": "480-834-8000",
"fax_number": "877-834-8008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21894 S 199TH WAY",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851427364",
"telephone_number": "480-834-8000",
"fax_number": "877-834-8008"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AZ ASSISTED LIVING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-25",
"last_updated": "2026-09-25",
"certification_date": "2026-09-25",
"status": "A",
"authorized_official_last_name": "GARRARD",
"authorized_official_first_name": "BRADY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "480-834-8000"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "167566",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Queen Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.