Organization Active NPI

Sunrise Assisted Living Home LLC

  • Assisted Living Facility
  • Goodyear, AZ
National Provider Identifier
1699562157
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
SUNRISE ASSISTED LIVING HOME LLC
Practice address
18413 W Pueblo Ave
Goodyear, AZ 85338-2014
Phone
(781) 346-1858
NPI assigned
Apr 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Mr. Jacob Awandem
Title
Co-Owner
Phone
(781) 346-1858

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

18413 W Pueblo Ave
Goodyear, AZ 85338-2014

Mailing address

18413 W Pueblo Ave
Goodyear, AZ 85338-2014

Other names 1

  • Sunrise Assisted Living Home Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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"
        }
    ]
}

Other providers in Goodyear, AZ

Sources for this page

  • 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.