Provider Demographics
NPI:1952954489
Name:JUBILEE IN THE DESERT, LLC
Entity Type:Organization
Organization Name:JUBILEE IN THE DESERT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY MANAGER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:SCARDEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-878-2273
Mailing Address - Street 1:13409 N 31ST PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-6026
Mailing Address - Country:US
Mailing Address - Phone:480-878-2273
Mailing Address - Fax:480-685-9939
Practice Address - Street 1:4321 W CHOLLA ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-3531
Practice Address - Country:US
Practice Address - Phone:480-878-2273
Practice Address - Fax:480-685-9939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility