Provider Demographics
NPI:1487351367
Name:J M J ADULT CARE HOME
Entity type:Organization
Organization Name:J M J ADULT CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARGUILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:602-841-9186
Mailing Address - Street 1:4833 E MARCONI AVE, SCOTTSDALE, ARIZONA 85254
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254
Mailing Address - Country:US
Mailing Address - Phone:619-316-5779
Mailing Address - Fax:602-801-3543
Practice Address - Street 1:7754 N 33RD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051
Practice Address - Country:US
Practice Address - Phone:602-841-9186
Practice Address - Fax:602-801-3543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAL12361HOtherASSISTED LIVING HOME