MEDICARE: OHANA FAMILY HOMES 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	311Z00000X	Custodial Care Facility

General Provider Information

NPI Number	:	1780574939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHANA FAMILY HOMES LLC

Provider Business Mailing Address
First Line	:	14155 N 83RD AVE STE 117
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85381-5640
Country	:	US
Telephone Number	:	602-341-6990
Fax Number	:

Provider Business Practice Location Address
First Line	:	14155 N 83RD AVE STE 117
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85381-5640
Country	:	US
Telephone Number	:	602-753-6076
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RYAN SENTERS
Credential	:
Telephone Number	:	623-363-8404

Provider Enumeration Date	:	07/08/2025
Last Update Date	:	01/19/2026

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Directions to “OHANA FAMILY HOMES LLC ” Practice Location

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