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General NPI Number Information
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NPI Number | 1730055716
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Entity Type | Organization
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Legal Business Name | JAYLA HOME BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 10/15/2025
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Last Update Date | 11/02/2025
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Provider Practice Location Address
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Address Line | 10620 W WOOD ST
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City | TOLLESON
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State | AZ
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Zip | 85353-5427
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Country | US
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Telephone | 208-389-8458
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Fax |
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Provider Business Mailing Address
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Address Line | 3316 S 78TH LN
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City | PHOENIX
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State | AZ
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Zip | 85043-1261
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Country | US
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Telephone | 208-389-8458
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Fax | 208-389-8458
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KANDI AMISI
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Credential |
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Telephone | 208-389-8458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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