Healthcare Provider Details

I. General information

NPI: 1407769763
Provider Name (Legal Business Name): GC ASSISTED LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6480 S ALAMEDA RD
GOLD CANYON AZ
85118-6888
US

IV. Provider business mailing address

6480 S ALAMEDA RD
GOLD CANYON AZ
85118-6888
US

V. Phone/Fax

Practice location:
  • Phone: 480-983-0939
  • Fax: 480-896-0800
Mailing address:
  • Phone: 480-983-0939
  • Fax: 480-896-0800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: BRADY GARRARD
Title or Position: PARTNER
Credential:
Phone: 480-983-0939