Healthcare Provider Details

I. General information

NPI: 1699511634
Provider Name (Legal Business Name): DJM FARMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 W CHICAGO ST STE 1B
COLDWATER MI
49036-1678
US

IV. Provider business mailing address

10959 W CHICAGO RD
ALLEN MI
49227-9404
US

V. Phone/Fax

Practice location:
  • Phone: 517-297-4181
  • Fax:
Mailing address:
  • Phone: 172-974-1815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DAVID JAMES MAJORS
Title or Position: OWNER
Credential:
Phone: 517-297-4181