Organization
ESTANCIA ASSISTED LIVING AT AVOCA PLACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUSTIN GODFREY (COO)
(480) 561-5590
Entity
Organization
Contact information
Practice address
2237 N AVOCA, MESA, AZ 85207-2028
(480) 561-5590
(409) 908-4682
Mailing address
16543 E ELGIN ST, GILBERT, AZ 85295-2003
(480) 561-5590
(409) 908-4682
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177782
—
AZ
Enumeration date
05/23/2025
Last updated
05/23/2025
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