JOLLEY FAMILY ASSISTED LIVING III
NPI 1881043503
Custodial Care Facility - Adult Care Home in Buckeye, AZ
- Organization
- Custodial Care Facility
- Adult Care Home
- CLIA Number: 03D1060099
- CLIA Cert. Type: Other
- CLIA Exp. Date: 10-15-2026
About JOLLEY FAMILY ASSISTED LIVING III
This page provides the complete NPI Profile along with additional information for Jolley Family Assisted Living Iii, a provider established in Buckeye, Arizona operating as a Custodial Care Facility, focusing in adult care home . The healthcare provider is registered in the NPI registry with number 1881043503 assigned on June 2016. The practitioner's primary taxonomy code is 311ZA0620X with license number AL8243H (AZ). The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Mrs. Fay Jolley-webster (Owner)
- NPI
- 1881043503 Verify this NPI
- Provider Name
- JOLLEY FAMILY ASSISTED LIVING III
- Entity Type
- Organization
- Location Address
- 20104 W BROADWAY RD BUCKEYE, AZ 85326
- Location Phone
- (623) 327-9573
- Location Fax
- (623) 327-9586
- Mailing Address
- 20110 W BROADWAY RD BUCKEYE, AZ 85326
- Mailing Phone
- (623) 386-2201
- Mailing Fax
- (623) 386-0189
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 06-03-2016
- Last Update Date
- 06-03-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Custodial Care Facility Adult Care Home
- Taxonomy Code
- 311ZA0620X
- Type
- Nursing & Custodial Care Facilities
- License No.
- AL8243H
- License State
- AZ
- Taxonomy Description
- A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 304300 | OTHER (01) | AZ | AHCCCS |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 03D1060099
- Facility Type
- Other
- Certificate Effective Date
- October 16, 2024
- Certificate Expiration Date
- October 15, 2026
- Laboratory Director
- FAY E. JOLLEY-WEBSTER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Jolley Family Assisted Living Iii to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1881043503, enumerated as an "organization" on June 03, 2016.
The provider is located at 20104 W BROADWAY RD BUCKEYE, AZ 85326 and the phone number is (623) 327-9573.
Custodial Care Facility with taxonomy code 311ZA0620X and a focus in Adult Care Home.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
