Healthcare Provider Details

I. General information

NPI: 1164357810
Provider Name (Legal Business Name): ROYAL DESTINY ASSISTED LIVING & MEMORY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2396 N 156TH DR
GOODYEAR AZ
85395-7546
US

IV. Provider business mailing address

2396 N 156TH DR
GOODYEAR AZ
85395-7546
US

V. Phone/Fax

Practice location:
  • Phone: 602-777-1634
  • Fax: 480-214-3135
Mailing address:
  • Phone: 602-777-1634
  • Fax: 480-214-3135

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: HECTOR RIVERA III
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 602-777-1634