Organization
JAYLEE INC
Active
Other names
emilys pl and vvv adult
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON GARRETT (PRESIDENT)
(480) 703-0329
Entity
Organization
Contact information
Practice address
140 W UNIVERSITY DR, MESA, AZ 85201-5818
(480) 703-0329
(480) 656-7676
Mailing address
140 W UNIVERSITY DR, MESA, AZ 85201-5818
(480) 703-0329
(480) 656-7676
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
AL4828H
AZ
310400000X
Assisted Living Facility
AL5055H
AZ
310400000X
Assisted Living Facility
AL6087
AZ
310400000X
Assisted Living Facility
Primary
AL6800H
AZ
310400000X
Assisted Living Facility
AL6982H
AZ
310400000X
Assisted Living Facility
AL7042H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096035
AHCCCS
AZ
01
—
224861
AHCCCS
AZ
01
—
240202
AHCCCS
AZ
01
—
316111
AHCCCS
AZ
01
—
878126
AHCCCS
AZ
01
—
929888
AHCCCS
AZ
Enumeration date
12/22/2010
Last updated
12/22/2010
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