Sunrise Assisted Living Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SUNRISE ASSISTED LIVING HOME LLC

Doing business as

Sunrise Assisted Living Home

Practice address

18413 W Pueblo Ave
Goodyear, AZ 85338-2014

Phone

(781) 346-1858

NPI assigned

Apr 21, 2025

Last updated

Apr 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jacob AwandemNPI 1295368579

Title

Co-Owner

Phone

(781) 346-1858

Specialties & licenses 1

Addresses

Other names 1

• Sunrise Assisted Living Home Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacob Zigo Awandem, RN

  • Home Health Registered Nurse
  • Peabody, MA
  • NPI 1295368579
  Authorized official Same address or phone

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

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1699562157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18413 W PUEBLO AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18413 W PUEBLO AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382014",
            "telephone_number": "781-346-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE ASSISTED LIVING HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-20",
        "status": "A",
        "authorized_official_last_name": "AWANDEM",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "781-346-1858",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Assisted Living Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sam Sun, M.D.
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• David T Sung, D.M.D.
• Gopinath S Sunil, MD
• Sunrise Mountain Behavioral Health
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• Surgicalist of Az PLLC
• Zachary Sutton, DO
• Kevin Lee Svancara, D.O.

• Assisted Living Facility in Goodyear, AZ
• Providers in Goodyear, 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 Apr 21, 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.