Goodyear Assisted Living Home, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GOODYEAR ASSISTED LIVING HOME, LLC

Doing business as

Goodyear Assisted Living Home

Practice address

14808 W Amelia Ave
Goodyear, AZ 85395-8205

Phone

(623) 600-8624

NPI assigned

Jan 17, 2023

Last updated

Jan 17, 2023By 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

Jacob AwandemNPI 1295368579

Title

Owner

Phone

(781) 346-1858

Specialties & licenses 1

Addresses

Other names 1

• Goodyear 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": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1730894569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14808 W AMELIA AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853958205",
            "telephone_number": "623-600-8624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14808 W AMELIA AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853958205",
            "telephone_number": "623-600-8624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODYEAR ASSISTED LIVING HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "AWANDEM",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-346-1858"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodyear Assisted Living Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Good Night Sleep Wellness Centers, Inc
• Good Years Family Medicine LLC
• Dustin Ryan Goodwin Jr.
• Goodyear Dental LLC
• Goodyear Dental LLC
• Goodyear Endodontics, P.C.
• Goodyear Endodontics, P.C.
• Goodyear Eye Specialists LLC (Goodyear Eye Specialists)

• 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 Jan 17, 2023; 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.