Provider Demographics
NPI:1659182699
Name:MJ ASSISTED LIVING GROUP LLC
Entity type:Organization
Organization Name:MJ ASSISTED LIVING GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:ROXAS
Authorized Official - Last Name:AGANON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-524-0557
Mailing Address - Street 1:4701 N 68TH ST UNIT 142
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-2097
Mailing Address - Country:US
Mailing Address - Phone:602-524-0557
Mailing Address - Fax:
Practice Address - Street 1:3437 W ACOMA DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-5620
Practice Address - Country:US
Practice Address - Phone:602-524-0557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility