MEDICARE: PURE ESSENCE FAMILY LIVING, 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	:	1629923511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURE ESSENCE FAMILY LIVING, LLC.

Provider Business Mailing Address
First Line	:	6416 W SADDLEHORN RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85083-3433
Country	:	US
Telephone Number	:	623-440-3287
Fax Number	:	623-440-3287

Provider Business Practice Location Address
First Line	:	6416 W SADDLEHORN RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85083-3433
Country	:	US
Telephone Number	:	623-440-3287
Fax Number	:	623-440-3287

Authorized Official
Title or Position	:	OWNER
Name	:	MOSES AMEZCUA-GUEMEZ
Credential	:
Telephone Number	:	480-932-4847

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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