Estancia Assisted Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ESTANCIA ASSISTED LIVING, LLC

Practice address

16543 E Elgin St
Gilbert, AZ 85295-2003

Phone

(480) 561-5590

Fax

(409) 908-4682

NPI assigned

Apr 24, 2023

Organization subpart

No

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

Authorized official

Name

Ashton Godfrey

Title

Ceo

Phone

(928) 243-3647

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1972291458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16543 E ELGIN ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952003",
            "telephone_number": "480-561-5590",
            "fax_number": "409-908-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16543 E ELGIN ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952003",
            "telephone_number": "480-561-5590",
            "fax_number": "409-908-4682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3517 S 159th St",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852972057",
            "country_code": "US",
            "telephone_number": "480-561-5590",
            "fax_number": "409-908-4682",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3260 E Tonto Ct",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852989195",
            "country_code": "US",
            "telephone_number": "480-561-5590",
            "fax_number": "409-908-4682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ESTANCIA ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "GODFREY",
        "authorized_official_first_name": "ASHTON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-243-3647"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Gilbert, AZ
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.