Organization
GOODYEAR ASSISTED LIVING HOME, LLC
Active
Other names
Goodyear Assisted Living Home
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB AWANDEM (OWNER)
(781) 346-1858
Entity
Organization
Contact information
Practice address
14808 W AMELIA AVE, GOODYEAR, AZ 85395-8205
(623) 600-8624
Mailing address
14808 W AMELIA AVE, GOODYEAR, AZ 85395-8205
(623) 600-8624
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
01/17/2023
Last updated
01/17/2023
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