Active NPI
Sunrise Assisted Living Home LLC
- Assisted Living Facility
- Goodyear, AZ
National Provider Identifier
1699562157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider DirectoryNPI 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.