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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:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
Adult Care Home
AZALH-4290

Other Provider Identifiers:

IssuerNumberStateType
788812AZ05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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