Organization
JOLLEY FAMILY ASSISTED LIVING III
Active
Parent organization
JOLLEY FAMILY ASSISTED LIVING, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JOLLEY FAMILY ASSISTED LIVING, LLC
Authorized official
MRS. FAY JOLLEY-WEBSTER (OWNER)
(602) 571-0529
Entity
Organization
Contact information
Practice address
20104 W BROADWAY RD, BUCKEYE, AZ 85326-5753
(623) 327-9573
(623) 327-9586
Mailing address
20110 W BROADWAY RD, BUCKEYE, AZ 85326-5753
(623) 386-2201
(623) 386-0189
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AL8243H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
304300
AHCCCS
AZ
Enumeration date
06/03/2016
Last updated
06/03/2016
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