JOLLEY FAMILY ASSISTED LIVING HOME II
Adult Care Home
Glendale, Arizona
Provider NPI: 1578764049
Organization Information:Organization Name: JOLLEY FAMILY ASSISTED LIVING HOME II
Practice Location:
5042 N 86TH DR GLENDALE, AZ 85305 US
Tel: 623-872-0032 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
5042 N 86TH DR GLENDALE, AZ 85305 US
Tel: 623-872-0032 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | AZ | ALH-4290 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
788812 | AZ | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin