{
"Npi": {
"NPI": "1578764049",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JOLLEY FAMILY ASSISTED LIVING HOME II",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5042 N 86TH DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GLENDALE",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85305-3313",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "623-872-0032",
"MailingAddressFaxNumber": "623-872-0033",
"FirstLinePracticeLocationAddress": "5042 N 86TH DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GLENDALE",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85305-3313",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "623-872-0032",
"PracticeLocationAddressFaxNumber": "623-872-0033",
"EnumerationDate": "05/30/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DUNCAN",
"AuthorizedOfficialFirstName": "SHARON",
"AuthorizedOfficialMiddleName": "LENORE",
"AuthorizedOfficialTitle": "CO-OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "623-872-0032",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "311ZA0620X",
"TaxonomyName": "Adult Care Home Facility",
"LicenseNumber": "ALH-4290",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}