Healthcare Provider Details

I. General information

NPI: 1063116127
Provider Name (Legal Business Name): AVERYS HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15843 E PRIMROSE DR
FOUNTAIN HILLS AZ
85268-3630
US

IV. Provider business mailing address

11624 E SHEA BLVD
SCOTTSDALE AZ
85259-5111
US

V. Phone/Fax

Practice location:
  • Phone: 888-672-2120
  • Fax:
Mailing address:
  • Phone: 602-694-9643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ANDREA STINER
Title or Position: BILLING DIRECTOR
Credential:
Phone: 602-694-9643