MEDICARE: AGAVIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1225993322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGAVIA LLC

Provider Business Mailing Address
First Line	:	2427 W DESERT HILLS ESTATE DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85086-4338
Country	:	US
Telephone Number	:	623-252-2421
Fax Number	:

Provider Business Practice Location Address
First Line	:	2427 W DESERT HILLS ESTATE DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85086-4338
Country	:	US
Telephone Number	:	623-252-2421
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MERLIS OLIVEROS GUERRA
Credential	:	NURSE PRACTITIONER
Telephone Number	:	623-252-2421

Provider Enumeration Date	:	12/19/2025
Last Update Date	:	12/19/2025

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Directions to “AGAVIA LLC ” Practice Location

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