Healthcare Provider Details

I. General information

NPI: 1053038554
Provider Name (Legal Business Name): AVARA CARE AT-HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

638 W BROADWAY RD STE 312
MESA AZ
85210-0908
US

IV. Provider business mailing address

1845 S DOBSON RD STE 205
MESA AZ
85202-5663
US

V. Phone/Fax

Practice location:
  • Phone: 804-500-8044
  • Fax:
Mailing address:
  • Phone: 480-490-7712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. BRYCE JOSHUA HAYS
Title or Position: OWNER
Credential:
Phone: 480-490-7712